Outcome for the first 85 patients treated with the functional endoscopic sinus surgery technique

Out of 85 patients operated on with the functional endoscopic sinus surgery (FESS) technique, 62 patients (73%), representing 105 operated sides, participated in an endoscopic follow-up with concomitant questionnaire concerning symptoms and patient's evaluation of the result. On 61 operative sides were performed polypectomies, 43 sides were operated on because of chronic recurrent sinusitis. Twelve patients (corresponding to 17 sides) were re-operated on. The mean follow-up period was 16 months for the patients with one operation, for those with re-operation it was 10 months. Eighty-two per cent of the patients reported subjectively marked or full improvement, 18% had experienced no change or slight improvement. By endoscopy, 43 operated sides (41.0%) were considered fully normal at follow-up. Residual polyposis was seen in 21 of 61 operated sides (35.9%) with pre-operative polyposis, and purulent discharge was seen in 11 sides (10.5% of all operated sides). The discrepancy between subjective satisfaction and objectively-assessed recurrent or residual pathology indicates a need for further elucidation of the aetiologies for chronic inflammatory sinonasal diseases. Obstruction of the drainage pathways around the ostiomeatal complex cannot explain all cases of sinusitis and is hardly aetiological in polyposis. Nevertheless, FESS is presently an adequate treatment in obtaining immediate relief in most cases of medically resistant sinusitis and polyposis.