Effectiveness of minimally invasive endoscopic sinus surgery in alleviating the symptom complex in chronic rhino-sinusitis


  • M. Santhosh Reddy Department of ENT, Malla Reddy Institute of Medical Sciences, Suraram, Hyderabad, Telangana
  • C. R. Vijay Bharath Reddy Department of ENT, Malla Reddy Institute of Medical Sciences, Suraram, Hyderabad, Telangana




Endoscopic sinus surgery, Septoplasty, Recurrence, Revision surgery


Background: Early surgical intervention has been found to be better in terms of patient satisfaction compared even with the medical management. The objective of the study was to study effectiveness of minimally invasive endoscopic sinus surgery in alleviating the symptom complex in chronic rhino-sinusitis.

Methods: Retrospective review of the chronic rhino-sinusitis data of 164 patients done, who undergone functional endoscopic sinus surgery with or without septoplasty between 2005 and 2013. Any recurrence of symptoms and radiological evidence recorded in the patient notes. The number of patients who undergone revision surgery also recorded.  

Results: The recurrence rate of symptoms and sinus disease was 20% (33 patients). There was no relation between the severity of the symptoms and the amount of disease seen in the CT scans. The two patients, who had purulent sinusitis, WERE completely relieved of their headaches and resumed their routine work soon after the operation. About 90% patients improved regarding nasal obstruction, 75% patients improved of nasal discharge, 60% patients showed improvement for sneezing. There were adhesions in about 6% patients and polyps recurred in 30% of patients. The recurrence of symptoms improved with medication in majority of patients.

Conclusions: The meticulously performed functional endoscopic surgery effectively improved symptom complex. If properly performed it is effective in alleviating all the symptoms and decrease recurrence rate and complications can be kept at negligible levels. Hence it offers a clear advantage in reducing complications and recurrence rates in sinus disease. 


Bhattacharyya N. Incremental health care utilization and expenditures for chronic rhino sinusitis in the United States. Ann Otol Rhinol Laryngol. 2011;120(7):423-7.

Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, Brook I, Kumar KA, Kramper M, et al. Clinical practice guideline (update): Adult Sinusitis Executive Summary. Otolaryngol Head Neck Surg. 2015;152(4):598-609.

Smith TL, Kern R, Palmer JN, Schlosser R, Chandra RK, Chiu AG, et al. Medical therapy vs. surgery for chronic rhino sinusitis: a prospective, multi-institutional study with 1-year follow-up. Int Forum Allergy Rhinol. 2013;3(1):4-9.

Jagdish C, Sunil N D, Pooja K, Roma V. Factors that Delay Definitive Management of Chronic Rhino sinusitis in India: A survey based study. Glob J Otolaryngol. 2016; 2(3):1-5.

Macbeth R. Caldwell Luc operation. 1952-1966. Arch Otolaryngol. 1968;87:630-5.

Ogura JH, Walsh TE. The trans-antral orbital decompression for progressive exophthalmos. Laryngoscope. 1962;72:1078-97.

Stammberger H, Posawetz W. Functional endoscopic sinus surgery. Concept, indications and results of the Messerklinger technique. Eur Arch Otolaryngol. 1990;247:63-76.

Bolger WE, Brown CL, Church CA, et al. Safety and outcomes of balloon catheter sinusotomy: A multicenter 24-week analysis in 115 patients. Otolaryngol Head Neck Surg 2007;137:107-12.

Catalano PJ, Payne SC. Balloon dilatation of the frontal recess in patients with chronic frontal sinusitis and advanced sinus disease: an initial report. Ann Otol Rhinol Laryngol. 2009;118:107-12.

Veloso-Teles R, Cerejeira R. Endoscopic sinus surgery for chronic rhino sinusitis with nasal polyps: Clinical outcome and predictive factors of recurrence. Am J Rhinol Allergy. 2017;31(1):56-62.

DeConde AS, Mace JC, Levy JM, Rudmik L, Alt JA, Smith TL. Prevalence of poly recurrence after endoscopic sinus surgery for chronic rhino sinusitis with nasal polyposis. Laryngoscope. 2017;127(3):550-5.

Lind H, Joergensen G, Lange B, Svendstrup F, Kjeldsen AD. Efficacy of ESS in chronic rhino sinusitis with and without nasal polyposis: a Danish cohort study. Eur Arch Otorhinolaryngol. 2016;273(4):911-9.

Cabrera-Ramirez MS, Dominguez-Sosa MS, Borkoski-Barreiro SA, Falcon-Gonzalez JC, Ramos-Macias A. Analysis and results of endoscopic sinus surgery in chronic rhino sinusitis with polyps. Acta Otorrinolaringol Esp. 2017;68(2):80-5.

Kim JE, Kountakis SE. The prevalence of Samter’s triad in patients undergoing functional endoscopic sinus surgery. Ear Nose Throat J. 2007;86(7):396-9.

Guerrero J, Molina B, Echeverria L, Arribas I, Rivera T. Endoscopic sinonasal surgery: study of 110 patients with nasal polyposis and chronic rhino sinusitis. Acta Otorrinolaringol Esp. 2007;58(6):252-6.






Original Research Articles