Radical versus Functional Endoscopic Sinus Surgery for Osteitis in Chronic Rhinosinusitis

Area of Science:

• Otolaryngology
• Surgical Innovation
• Inflammatory Sinus Disease

Background:

• Osteitis is a key factor in chronic rhinosinusitis (CRS) severity and treatment resistance.
• Transnasal endoscopic surgery presents a viable treatment option for CRS-related osteitis.
• Understanding surgical outcomes is crucial for managing complex CRS cases.

Purpose of the Study:

• To compare the surgical outcomes of radical endoscopic sinus surgery (RESS) versus functional endoscopic sinus surgery (FESS) in patients with osteitis and CRS.
• To evaluate the influence of these surgical approaches on disease severity and inflammatory markers.

Main Methods:

• Retrospective analysis of 51 patients diagnosed with osteitis in CRS via CT scan.
• Patients were divided into RESS (n=24) and FESS (n=27) groups.
• Outcomes assessed using symptom visual analog scale (VAS), blood eosinophils, IgE, skin prick tests, endoscopy (Lund-Kennedy score), CT (Lund-Mackay score), and Global Osteitis Scoring Scale (GOSS).

Main Results:

• No significant differences in age, gender, or comorbidities (allergic rhinitis, asthma) between groups.
• Preoperative VAS and Lund-Kennedy scores were higher in the RESS group; Lund-Mackay and GOSS scores were similar.
• One year post-surgery, both groups showed significant improvement in VAS, Lund-Kennedy, and Lund-Mackay scores.
• The RESS group demonstrated significantly lower Lund-Kennedy and Lund-Mackay scores compared to the FESS group one year after surgery.

Conclusions:

• Radical endoscopic sinus surgery (RESS) is more effective than functional endoscopic sinus surgery (FESS) in reducing the inflammatory burden in patients with osteitis and CRS.
• RESS offers superior outcomes in improving sinus inflammation and patient-reported symptoms.