[Microscopic endonasal sinus surgery (MESS) in nasal polyposis: long term results]

The endonasal microscopic sinus surgery (EMSS) in polyposis nasi is a grateful and in most cases successful procedure with a relative low risk of complications. In 1988 and 1989 we operated on 302 patients with polyposis nasi following the "Heermann Concept of EMSS". In each case the total ethmoidectomy with maxillary, sphenoid and frontal sinus surgery was performed. After an average of 5.2 years we started a follow-up in 185 patients including a questionnaire and clinical examination with endoscopic control and olfactometry. We found recurrent polyposis in 17.3% and a reoperation was necessary only in 6.5%. The complaints in polyposis as nasal obstruction, frontal cephalgia and hyposmia could be improved in more than 80%. About 26.5% of our patients suffered from bronchial asthma. Every second of them (51%) saw an improvement of asthma complaints after the operation. It is remarkable, that the clinical and endoscopic findings do not correlate in all cases with the subjective judgement of the patients. We saw patients with manifest recurrent polyposis, who did not deplore any complaints and vice versa. At last 85.4% said, that they would undergo the operation again.