Vol. 1, Issue 2 (2012)

Background and Objective: Chronic rhinosinusitis (CRS) is a persistent inflammatory condition of the paranasal sinuses that significantly impacts patients' quality of life. While medical therapy remains the first line of treatment, a subset of patients require surgical intervention for symptom relief and disease control. This study aimed to evaluate the clinical outcomes and effectiveness of functional endoscopic sinus surgery (FESS) in patients with chronic rhinosinusitis who were unresponsive to medical therapy.

Material and Methods: This prospective study included 50 patients diagnosed with chronic rhinosinusitis, refractory to at least 12 weeks of standardized medical treatment. This study was conducted at the Department of Oto-Rhinolaryngology, Annaii Medical College and Hospital, Pennalur, Sriperumbudur, Chennai, Tamil Nadu, India from February 2011 to January 2012. All patients underwent FESS under general anesthesia. Preoperative assessment included detailed history, nasal endoscopy, CT scan of the paranasal sinuses, and symptom scoring using the Lund-Mackay and SNOT-22 scales. Postoperative evaluations were conducted at 1, 3, and 6 months to assess symptom relief, endoscopic findings, and complication rates.

Results: Out of 50 patients, 38 (76%) showed significant improvement in symptoms within the first 3 months postoperatively, with sustained improvement at 6 months. The mean SNOT-22 score reduced from 52.6±10.2 preoperatively to 21.3±8.5 at 6 months (p<0.001). Endoscopic findings revealed reduced mucosal edema, improved drainage, and decreased crusting in the majority of cases. Minor complications such as nasal synechiae occurred in 3 patients (6%), while no major complications were reported.

Conclusion: Endoscopic sinus surgery is a safe and effective modality in the management of chronic rhinosinusitis unresponsive to medical therapy. It significantly improves both subjective symptoms and objective clinical findings, contributing to enhanced patient outcomes and quality of life.