[Endoscopic surgery of chronic sinusitis]

Between 1984 and 2000 the author has performed endoscopic sinus surgery (ESS) in 1072 patients with chronic sinusitis resistant to medical therapy. In 201 patient (19%) the operation was limited to the maxillary sinus and in 871 patients (81%) multiple cavities were involved. Ethmoidectomy was performed for 749 patients (70%) of which polyposis was found in 315 (29%), bilateral in (87%). History of previous sinus surgery was found in 399 patients (37%). This retrospective study with a long-term follow-up (average 8.6 years) analyzes the objective and subjective result in 212 patients after ESS for pansinusal polyposis. Subjective success rates were noted in 92% of patients after 1 year; in 78% after 5 years and in 82% 8.6 years after ESS. The best results were obtained in nasal breathing which was significantly improved in 91% of patients, the poorest results were noted in olfaction which was improved in 60% of cases. Objectively, the endoscopic findings were normal in 86% of cases after 1 year; in 81.6% after 5 years and in 79.2% 8.6 years after ESS. 26 patients (12.2%) underwent revision surgery. In 100 patients (47%) the polyposis was massive, associated with allergy in 82 cases (39%), asthma in 67 patients (31%), Aspirin sensitivity in 24 patients (11.1%) and Samter's syndrome in 19 patients (9%). In 1072 patients major complications occurred in 4 cases (0.4%). On case of delayed hemorrhage required cautery of the sphenopalatine artery and transfusions. Three other cases of CSF leak were repaired during ESS without sequel.