Functional Endoscopic Sinus Surgery Comparison in a Tertiary Care Hospital

Abstract

Two of the commonest indications for FESS are chronic rhinosinusitis without polyps and chronic rhinosinusitis with ethmoid polyps. This prospective study was carried out in Manipal Teaching Hospital, Pokhara to compare the results of FESS for bilateral chronic rhinosinusitis with and without ethmoid polyps. The study comprised of a cohort of 104 patients with bilateral chronic rhinosinusitis who underwent FESS between January 2012 and December 2014. The patients were divided into group 1 (without ethmoid polyps) and group 2 (with ethmoid polyps). Results in the two groups were assessed by comparing the Lund-Kennedy nasal endoscopic grading scores and Sino Nasal Outcome Test (SNOT-22) scores. Statistical analysis was done with Statistical Package for Social Sciences (SPSS) version 16.0. Statistical significance was set at p<0.05. The Lund-Mackay CT scan mean scores for group 1 and group 2 were 14.02 and 15.28 respectively before surgery (p = 0.11). Lund-Kennedy endoscopic score 3 months after FESS were much better in group 2 patients than in group 1(p<0.00001). After FESS, there was significant improvement in SNOT-22 scores in both groups. The SNOT-22 scores 3 months after FESS were much better in patients of group 2 than in patients of group 1(p<0.0001). The improvement in post-operative endoscopic grading and SNOT-22 scores wasmore in patients of chronic rhinosinusitis with ethmoid polyps than in patients without ethmoid polyps. There was no improvement in decreased sense of smell after FESS in most patients with ethmoid polyps.