Endonasal microendoscopic pansinusoperation in chronic sinusitis. II. Results and complications.

PURPOSE

We evaluated the long-term results and complications of endonasal pansinusoperation in chronic polypoid sinusitis.

PATIENTS AND METHODS

In a retrospective study, 170 patients were followed-up for 20 months to 10 years after bilateral endonasal microendoscopic pansinus surgery or ethmoidectomy. The follow-up consisted of a standardized questionnaire and clinical examination with the flexible endoscope.

RESULTS

We found that 85.6% of the ethmoid cell systems, 69.4% of maxillary sinuses, and 37.5% of frontal sinuses could be visualized endoscopically. The ethmoid mucosa was normal in 56% and thickened in 19%. Recurrent polyps were found in 25%. The evaluation--as per the graduation of results defined by us as a combination of examination findings and subjective assessment of the operative result--resulted in an operative success of 92%. Two studies dealing with the frequency of complications showed injury to the dura in 2.3% to 2.55% and periorbital injury without permanent sequelae in 1.4% to 3.4%. Because of two cases of bleeding from the internal carotid artery, the problems of vascular complications in particular will be thoroughly discussed.

CONCLUSION

More than 90% of patients with chronic polypoid sinusitis gain long-term satisfying results after endonasal ethmoidectomy with microscope and endoscope. For minimizing the risk of injury of the optic nerve or the internal carotid artery preoperative, computed tomography is necessary. A special training program is recommended.