Outcome in patients with chronic sinusitis after the minimally invasive sinus technique

Controversy persists regarding the use of minimally invasive sinus techniques (MIST) to treat chronic sinusiris primarily because of an absence of comparative outcome data.

In this prospective study of 85 patients with chronic sinusitis treated surgically with MIST, the long-term postoperative outcome was assessed using the duration-based Chronic Sinusitis Survey (CSS) quality of life instrument. Patient age ranged from 4 to 81 years old (mean age, 42 +/- 16.7 years). Forty-three subjects were male patients and 42 were female patients. Mean follow-up time was 23.8 +/- 2.2 months.

At follow-up, there was a 124.0% improvement in the mean CSS symptom score (p < 0.00001), a 30.1% improvement in the mean CSS medication score (p < 0.00001), and a 62.0% improvement in the mean CSS total score (p < 0.00001). An overall improvement was found in 78.8% of patients; 12.9% of patients were worse and 8.2% of patients were unchanged. Thirty-four patients (40.0%) had postsurgical CSS total scores within the normative interquartile range obtained in healthy controls. Twenty-six of these patients had postsurgical scores that actually surpassed the mean normative CSS total score. Before follow-up evaluation, 5 of the 85 patients (5.9%) had revision surgery after the initial procedure. All had revision MIST procedures and all were found to have an overall improvement at the time of follow-up.

We conclude that MIST significantly improves the outcome in patients with chronic sinusitis and should strongly be considered as the initial surgical option for such patients.