A Hospital Based Prospective Study of Impact of Endoscopic Sinus Surgery on Symptoms Manifestations of Chronic Rhino Sinusitis

Abstract

Background: FESS has gained popularity and continues to do so among the ENT surgeons in the recent years with the better understanding of the lateral wall of the nose. Most cases of chronic rhinosinusitis respond to medical treatment but if no improvement in symptoms is achieved, FESS advocates systematic approach to the surgical treatment of the disease of the nose and sinuses. The aim of this study to assess the impact of endoscopic sinus surgery on symptoms manifestations of chronic rhino sinusitis. Materials & Methods: A hospital based prospective study done on 50 patients attending ENT Outpatient Department at government medical college Sikar, Rajasthan, with clinical features and investigations suggestive of CRS were randomly selected. Patients with at least two major, or one major and two minor criteria/sinus symptoms were considered. All their symptoms were graded preoperatively as mild (1) moderate (2) or severe (3) (grade 0 allotted for no symptoms). Endoscopic examination was performed preoperatively and at each postoperative visit. Results: The average age of the patients in the study was 39 years, 32 patients were males (64%) and 18 patients were females (36%). The average duration of the patients was 5 years and 3 months. Bilateral disease was observed in 46 patients and 4 patients had unilateral disease two in the right and other two in the left. The most common symptom was nasal obstruction (N=43, 86%) from the major criteria followed by headache (N=40, 80%) from the minor criteria. Post operatively the patient satisfaction over-all based on the symptom profile was high. 86% of the patients in the study felt Much Better (p value <0.001) after the treatment with FESS. Conclusion: We concluded that FESS is the best available treatment modality for Chronic Rhinosinusitis. Symptomatic relief was successfully established in 86%of patients who fail to respond to medical treatment.