Abstract
Treatment of sinonasal diseases is either conservative or surgical. The recent advances in surgical management is the use of endoscopic sinus surgery (ESS) as it causes less morbidity, complication, pain and above all, less recurrence rates. This study aimed to evaluate the effectiveness of ESS for the treatment of nasal & paranasal sinus diseases and to address the postoperative complications. A prospective study was done at the Department of Otolaryngology in Basrah Teaching Hospital in the period from January 2016 to August 2019. One hundred twenty six patients with sinonasal diseases were involved in this study, more than this number of patients was operated upon but they either refused participation in this study or dropped from follow-up. The main indications of surgery were; chronic rhinosinusitis without nasal polyp (33%), chronic rhinosinusitis with nasal polyp (28.6%), Allergic fungal sinusitis & mycetoma (17.4%), and acute recurrent sinusitis (16%). Main presenting symptoms were; nasal obstruction (85.7%), nasal discharge (69%), headache and facial pain (66.6%) and hyposmia and or anosmia (57.9%). The majority of operated upon patients were primary cases (98 patients, 77.7%), while (28 patients, 22.2%) were revision cases. The commonest causes of revision were; retained or incompletely removed uncinate process in 28.5% of cases, followed by incomplete removal or persistence of anterior ethmoid cells in 21.4% cases. In this series complications occurred in 15%, which were generally minor (9.5%), major complications occurred in 5.5% of operated upon patients. The commonest major complication is sever bleeding which was reported in 4.7% and anosmia which was reported in one patient. No CSF leak, retro orbital haemorrhage, or blindness was reported. Most of the patients in this series were improved (88.8%), complete symptom improvement occurred in (75 patients, 59.5%), partial improvement (37 patients, 29.3%), while (14 patients, 11%) were not improved. In conclusion, functional endoscopic sinus surgery is a safe surgery for sinonasal diseases, it carry good success rate with non-significant major complications. Key words: Nasal Sinus, Functional Surgery, Endoscopy
Highlights
Treatment of sinonasal diseases is either conservative or surgical
Functional endoscopic sinus surgery is a set of minimally invasive surgical techniques which permit direct visual examination and opening of the sinuses for the treatment of chronic rhinosinusitis which has not improved by medical treatment3,4
Posterior ethmoidectomy was done by identifying the ground lamella posterior to the bulla, which was pierced by a upcutting forceps, any other pathology was dealt likewise, merocele pack was kept to be removed after 24 hours8,9, patients were followed-up for 6 months
Summary
The recent advances in surgical management is the use of endoscopic sinus surgery (ESS) as it causes less morbidity, complication, pain and above all, less recurrence rates. This study aimed to evaluate the effectiveness of ESS for the treatment of nasal & paranasal sinus diseases and to address the postoperative complications. The commonest causes of revision were; retained or incompletely removed uncinate process in 28.5% of cases, followed by incomplete removal or persistence of anterior ethmoid cells in 21.4% cases In this series complications occurred in 15%, which were generally minor (9.5%), major complications occurred in 5.5% of operated upon patients. The aim of present study is to evaluate the effectiveness of FESS for the treatment of nose & paranasal sinus diseases, and to address the postoperative complications
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