Functional and Clinical Outcomes of Endoscopic Sinus Surgery in Patients with Chronic Rhinosinusitis

Open Access

Abstract

Background: Chronic rhinosinusitis (CRS) is a common inflammatory disorder that affects the paranasal sinuses, severely limiting quality of life and daily functioning. Endoscopic sinus surgery (ESS) has emerged as the major surgical treatment option for medically resistant CRS. This study aims to assess the functional and clinical outcomes of ESS in individuals with chronic rhinosinusitis who have failed conservative medical treatment. Methods & Materials: Thisprospective observational study was conducted among 80 patients at Department of Otolaryngology-Head & Neck Surgery, Bangladesh Medical University, Dhaka with chronic rhinosinusitis undergoing endoscopic sinus surgery between July 2023 and June 2024. Patients with CT-confirmed CRS who had failed at least 12 weeks of acceptable medical therapy were eligible for inclusion. Patients with cancer, immunodeficiency, or a history of sinus surgery were excluded. The Sino-Nasal Outcome Test-22 (SNOT-22) questionnaire was used to measure functional results before surgery, as well as three and six months later. Clinical indicators such as nasal blockage, facial pain, and endoscopic results were assessed. Data were entered and analyzed using SPSS version 26. Results: At 3 and 6 months, the mean SNOT-22 score dropped from 52.6±11.4 to 24.8±8.9 and 18.2±7.1, respectively (p<0.001). Significant progress was made in the following major symptoms: nasal discharge dropped from 82.5% to 17.5%, facial pain from 72.5% to 12.5%, and nasal blockage went from 90.0% to 20.0%. On endoscopy, 70.0% of patients showed normal mucosal status at the 6-month follow-up. Just 10.0% of patients experienced synechiae development, and 7.5% had persistent illness, indicating low complications. Conclusion: Endoscopic sinus surgery provides excellent functional and clinical outcomes in individuals with medically resistant chronic rhinosinusitis, with persistent improvement in quality of life and symptom control at 6-month follow-up.