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Factors Contributing For the Best Outcome of Functional Endoscopic Sinus Surgery

Madha Medical College and Research Institute, Kovoor, Chennai

Objective: To study the factors contributing for the best outcome of functional endoscopic sinus surgery Design: Prospective case series

Setting: Academic tertiary medical centre

Patients: 100 cases with chronic sinonasal inflammatory diseases who underwent functional endoscopic sinus surgery were studied

Main outcome measures: Subjective and objective endoscopic evaluation of postoperative improvement Results: Local anaesthesia is comfortable and cost effective for most (71%) of the patients with minimal intraoperative bleeding. Intraoperative mucosal injury led to stenosed maxillary sinus ostia in 2% of the patients and postoperative nasal synechae in 13% patients. Co morbid Bronchial asthma (2% of recurrence) and allergic risk factor (4% of recurrence) are the major factors contributing for postoperative recurrence. Preoperative oral and local steroids for 15% of the patients with bilateral sinonasal polyposis helped intraoperatively to reduce the size of the polypi, better delineation of anatomy and reduced intraoperative bleeding. Postoperative nasal saline douching and Saline spray were found to be equally effective in reducing nasal crusts formation

Conclusion:With best anatomic knowledge, cadaveric dissection training, preoperative medical management as required, customized mucosal preservation surgical technique and postoperative care, the best outcome of FESS can be achieved.