A STUDY ON THE CAVITY PROBLEMS IN PATIENTS WHO HAVE UNDERGONE FUNCTIONAL ENDOSCOPIC SINUS SURGERY

Abstract

Background: Studies on the postoperative problems of endoscopic sinus surgery are rare in literature. The objective is to study the postoperative symptoms of patients and findings on nasal endoscopy after functional endoscopic sinus surgery (FESS). Adequate postoperative care necessary after FESS and ways to reduce the cavity problems to be studied.

Methods: 113 patients who underwent FESS for various pathologies were followed up at regular intervals with nasal endoscopy. Postoperative symptoms of patients were documented, nasal endoscopy done and findings noted. Necessary interventions performed according to the problems visualized. Results were analysed at 1 month and 3 months post surgery and as required thereafter.

Results: Postoperative review at 1 month showed symptoms of smell disturbances (24 cases), nasal obstruction (16 cases), headache(4) and nasal discharge(2). Nasal endoscopy revealed synechiae in 16 patients, significant crusting and fungal debris in 11 patients each. AFRS (17 out of 25 cases) and ethmoidal polyps (19 out of 52 cases) had maximum problem rate. Procedure wise, revision FESS and cases with septal correction showed maximum problems. Necessary intervention performed. Review at 3 months showed persistent smell disturbances in 6 ethmoidal polyp cases and persistent fungal debris in 5 of the AFRS cases. Rest of the cases improved. Outside this review, 1 case of antrochoanal polyp and 9 cases of ethmoidal polyps showed recurrence later on which was treated endoscopically.

Conclusion: AFRS and ethmoidal polyps require rigorous postoperative care with nasal endoscopy and appropriate intervention as they are prone for recurrence and postoperative problems. Revision FESS need extensive preoperative assessment to reduce problem rate. Duration of follow up necessary for each case need more extensive long term studies.