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Updated: Sep 9, 2026
Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
Comparative outcomes of nasalisation vs functional endoscopic sinus surgery in chronic rhinosinusitis with nasal
Dubravko Manestar1,2, Ema Ahel Ledić1,2, Svjetlana Janković3
1Clinic of Otorhinolaryngology and Head and Neck Surgery, Clinical Hospital Centre Rijeka, Croatia.
Objective:
To compare outcomes of functional endoscopic sinus surgery (FESS) and nasalisation (radical ethmoidectomy) in chronic rhinosinusitis with nasal polyposis (CRSwNP), and to identify subgroups benefiting most from nasalisation.
Methods:
We retrospectively analysed 480 surgeries (374 FESS, 106 nasalisation) from 2012 to 2022. Nasalisation patients had more severe baseline disease than FESS patients (mean Nasal Obstruction Symptom Evaluation [NOSE] score: 76.88 ± 6.18 vs 73.55 ± 7.25; mean Visual Analogue Scale [VAS] olfaction score: 6.53 ± 1.1 vs 8.8 ± 1.15; mean Lildholdt score: 2.09 ± 0.76 vs 1.57 ± 0.83; all p < 0.001). Subjective (NOSE, VAS) and objective (Lildholdt) scores were recorded preoperatively and at one, 3, 6, 12, and 24 months postoperatively.
Results:
Despite worse baseline status, nasalisation showed greater improvements in subjective and objective measures, and was particularly effective in diffuse extensive polyposis. Paired t-tests confirmed significant postoperative enhancements (all p < 0.001; Cohen's d > 0.8). At 24 months, nasalisation showed superior outcomes: NOSE (24.5 ± 5.5 vs 41 ± 6), VAS olfaction (1.95 ± 1.05 vs 3.95 ± 1.15) (both p < 0.001); Lildholdt scores were similar (0.5 ± 0.6 vs 0.53 ± 0.65; p = 0.68).
Conclusions:
The preliminary results of this retrospective study showed that nasalisation in more severe cases of CRSwNP yielded better long-term clinical outcomes. These results motivate for further investigation through a prospective study that will include comprehensive olfactory testing, quality of life measures, and a more complete methodology with refined variables to address the limitations of the current data set.
