Results and prognostic factors in the radical sinus operation for chronic sinusitis

Radical surgical procedures of the maxillary sinus with or without involvement of the ethmoid, sphenoid and frontal sinuses were performed in 382 adult patients in the Department of Otorhinolaryngology. Tokai University Hospital in the 8-year period from 1984 to 1991. Of 382 patients, the postoperative symptomatology was studied in 189 patients by mcans of questionnaires. The postoperative results were finally analyzed in 63 patients whose subjective symptoms and objective findings were completely recorded. The follow-up period was over 3 months and subjective postoperative improvement was achieved in 83% and objective postoperative improvement in 75%; the overall improvement rate was 73%. In an analysis of results of the radical surgical operation, it appeared that poor results were closely related to the following factors: (1) maxillary sinus mucosa with cellular infiltration or edematous changes; (2) multiplicity of bacterial species including Gram-negative rods isolated from maxillary sinus secretion; (3) poor mucociliary clearance function; and (4) unsatisfactory postoperative treatment.