Data:

Symptomatic questionnaires (Thai language) were filled (ticked) by 100 patients/subjects (without influence of the surgeon) before entry to an examination room of a department of otolaryngology. Symptoms were later scored as 0 = no , 1 = mild, 2 = moderate and 3 = severe.

These subjects were later divided into 3 groups: (a) medium-term group/MTG, (b) long-term group/LTG and (c) patients who either failed to attend the required minimum follow-up period of one year or attended follow-ups elsewhere. Details of patients in group (c) were not analyzed.

Therefore, symptomatic data were considered only in the MTG (1-5 years after FESS) and the LTG (5-10 years after FESS). A score change of at least “1” was needed for improvement (symptom score of minus 1 or more) or
worsening of symptom (symptom score of plus 1 or more). Among 100 FESS cases, results were obtained from 64
MTG cases and 8 LTG cases.

Results:

In the MTG [Table 1], improved symptoms comprised postnasal drip 40 out of (/) 61 patients (Pts) (65.57%), rhinorrhoea 32 / 59 Pts (54.24%), nasal obstruction 20 / 51 Pts (39.22%), facial pain 20 / 32 Pts (62.5%), sneezing 13 / 29 Pts (44.83%) and cacosmia 19 / 26 Pts (73.08%).

In the LTG [Table 2], improved symptoms comprised rhinorrhoea 5 / 6 Pts (83.3%), postnasal drip 5 / 8 Pts (62.5%), nasal obstruction 6 / 8 Pts (75%), facial pain 5 / 5 Pts (100%), sneezing 0 / 4 Pts (0%) and cacosmia 4 / 5 Pts (80%). Actually, the percentages in this LTG group do not bear much weight because of the small numbers.

Eleven out of 64 cases i.e. 17.19% in the MTG underwent RESS and five out of 8 cases i.e. 62.5% in the LTG underwent RESS (six operations). In all, 16 out of 72 cases i.e. 22% had RESS. Among the MTG and LTG, 14 / 16 cases i.e. 87.5% had surgery to the frontal sinus(es) and 12/ 16 cases i.e. 75% had surgery to the sphenoidal sinus(es).

Conclusions:

(i) In MTG, symptomatic improvement outcomes occurred in the range of 39.22% - 73.08%: nasal obstruction 20 /
51 Pts (39.22%), sneezing 13 / 29 Pts (44.83%), rhinorrhoea 32 / 59 Pts (54.24%), facial pain 20 / 32 Pts (62.5%), postnasal drip 40 / 61 Pts (65.57%) and cacosmia 19 / 26 Pts (73.08%); and, RESS was performed in 11 / 64 Pts
(17.19% of the cases).

(ii) In the LTG, symptomatic improvement outcomes occurred in the range of 0 – 100%: sneezing 0 / 4 Pts (0%), postnasal drip 5 / 8 Pts (62.5%), nasal obstruction 6 / 8 Pts (75%), cacosmia 4 / 5 Pts (80%), rhinorrhea 5 / 6 Pts (83.33%) and facial pain 5 / 5 Pts (100) but these numbers were too small for proper percentages; and, RESS was performed in 5 / 8 Pts (62.5% of the cases).

(iii) In considering follow-ups of 1- 10 years, 16 / 72 cases (22.22%) underwent RESS 17 times; and, 14 / 16 cases i.e. 87.5% had surgery to the frontal sinus(es) and 12 / 16 cases i.e. 75% had surgery to the sphenoidal sinus(es).

(iv) Patients should be given information that several symptoms may improve but patients should not expect relief or resolution of all symptoms.

Table 1. Symptoms and Patients (N = 64) in Medium-Term Group (1-5 Years)

[ colour codes: green = improved symptom(s), brown = no change in symptom(s), red = worse symptom(s) ]

NB. Among 64 patients, frequencies of pre-FESS symptoms were postnasal drip 61 / 64 (95.3%), rhinorrhoea 59 / 64 (91.19%), nasal obstruction 51 / 64 (79.69%), facial pain 32 / 64 (50%), sneezing 29 / 64 (45.31%) and cacosmia 26 /
64 (40.63%).