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Endoscopic Surgical Management of Sphenoid Sinus Disease
Author(s) -
Rosen Frederick S.,
Sinha Uttam K.,
Rice Dale H.
Publication year - 1999
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-199910000-00010
Subject(s) - medicine , sinusitis , patient satisfaction , surgery , endoscopic sinus surgery , sinus (botany) , endoscopy , retrospective cohort study , logistic regression , botany , biology , genus
Objectives: To assess the outcome of functional endoscopic sphenoid sinus surgery, and to determine the predictors of outcome. Study Design: Retrospective chart review of 651 consecutive endoscopic sinus procedures performed between 1992 and 1997. Setting: USC University Hospital, University of Southern California, Los Angeles. Materials and Methods: Seventy‐four patients (11.4% of all endoscopic procedures) with sphenoid sinus disease were selected. All 74 patients were mailed a sinusitis‐specific questionnaire, and 46 of them (62.2%) responded. Outcome measures derived from clinician ratings were applied to all 74 patients, and those derived from self‐report were applied to 46. Outcome measures were determined from patient questionnaires at a minimum of 6‐month postoperative follow‐up, operative complications, and clinician perceptual ratings. Patient questionnaires addressed general patient satisfaction, symptom score, and medication usage. A statistical analysis was performed using χ 2 test, linear regression, and one‐way nonparametric ANOVA. Results: Favorable surgical outcomes based on general patient satisfaction (84.8%, n = 39) and clinician perceptual rating (78.4%, n = 58) were noted. Minor postoperative complications were noted in 10 patients (13.5%) and 8 patients (10.8%) needed revision endoscopic procedures during follow‐up. Of the complications, eight (80%) occurred in revision endoscopic procedures. The use of an expanded, sinus‐specific symptom score revealed far fewer favorable outcomes (56.5%, n = 26). Seven outcome predictors were established, although none of the predictors held for more than one of the six outcome measures used. Conclusion: Endoscopic sphenoid sinus surgery is safe and effective. An expanded symptom score is recommended to assess the outcome of this procedure.