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Otorinolaringologia 1998 September;48(3):95-9


language: Italian

Evaluation of the results of endoscopic sinus surgery. Problems and proposals

Meloni F., Stomeo F., Bozzo C., Canu M.

Università degli Studi - Sassari Istituto di Oftalmologia, Otorinolaringoiatria e di Urologia


Background. An attempt to retrospectively evaluate the results obtained with ESS (Endoscopic Sinus Surgery) in the treament of 102 patients with massive nasal polyposis, operated on from 1989 to 1993 using exclusively the endoscopic technique described by Messerklinger is presented.
Methods. The clinical follow-up was completed by the patient’s self-assessment of the persistence or improvement of symptoms after the operation. The follow-up was carried out by means of serial endoscopic examinations, in which, in conjunction with the control of the operated cavities, patients were asked to fill out a questionnaire based on the evaluation of symptoms usually linked to the presence of nasal polyposis, and, in addition, on their possible modifications after the treatment. A progressive score was given to the symptoms, depending on their severity or frequency.
Results. The analysis of the results revealed that 78% of the patients showed an agreement between a negative examination and a low score. Among the 22 patients with a high score (21% of all patients), in 15 (16%) alterations in the endoscopic pattern were found, thus indicating a substantial overlap between self-assessment and objective observation, while in the remaining 7 patients (6%) the high score disagreed with the endoscopic aspect of the cavities. Those patients represent the false positives, since if they had been judged exclusively from their endoscopic appearance, they would have been classified among the successes of this technique.
Conclusions. By adding the subjective element, the usefulness of the test proposed would thus consist in the detection of those patients in which the surgical treatment, even if technically correct, has only partly improved the symptoms caused by chronic polypoid rhinosinusitis.

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