Outcomes Of Functional Endoscopic Sinus Surgery (FESS) In Patients With Chronic  Rhinosinusitis With Nasal Polyps : Original Article

Tahreem Fatima; Shakir Ullah; Imran khan; Mushtaq Ahmad; Muhammad Afaq; Osama Nawaz; Wasigh Ali

doi:10.69837/pjammr.v3i2.78

Authors

Tahreem Fatima Post graduate Trainees in ENT Department Khyber Teaching Hospital Peshawar https://orcid.org/0000-0001-7545-3117
Shakir Ullah Registrar ENT Department Khyber Teaching Hospital Peshawar https://orcid.org/0000-0002-7559-2886
Imran khan Assistant Professor ENT Department Khyber Teaching Hospital Peshawar https://orcid.org/0000-0003-3152-2189
Mushtaq Ahmad Post graduate Trainees in ENT Department Khyber Teaching Hospital Peshawar https://orcid.org/0000-0002-4246-1193
Muhammad Afaq Post graduate Trainees in ENT Department Khyber Teaching Hospital Peshawar
Osama Nawaz Post graduate Trainees in ENT Department Khyber Teaching Hospital Peshawar
Wasigh Ali Post graduate Trainees in ENT Department Khyber Teaching Hospital Peshawar

DOI:

https://doi.org/10.69837/pjammr.v3i2.78

Keywords:

FESS, CRWNP, Outcomes, Recurrence

Abstract

Background: Chronic rhino sinusitis with nasal polyps (CRS with NP) is a chronic inflammatory condition characterized by nasal congestion, olfactory dysfunction, and a diminished quality of life. Functional endoscopic sinus surgery (FESS) has emerged as a preferred treatment option for patients who do not respond adequately to medical management. While FESS is associated with improvements in symptom control and quality of life, the recurrence of polyps remains a significant concern, along with varying treatment outcomes. Therefore, it is crucial to assess the effectiveness and post-surgical outcomes of FESS in CRS with NP to optimize patient management strategies.

Objectives: To evaluate clinical outcomes, symptom relief, and quality-of-life improvement after FESS in patients with (CRS with NP) and discuss the results in relation to factors associated with recurrence and postoperative recovery.

Study design: A Cross-sectional study.

Place and Duration of study: Department of ENT Khyber Teaching Hospital Peshawar From January 2023 to January 2024

Methods: A Cross-sectional study was performed on patients diagnosed with (CRS with NP) FESS. Systems preoperative assessment was performed by symptom scoring with SNOT-22 and endoscopic probing. Follow-up was performed postoperatively after 3, 6 and 12 months with an evaluation of the symptomatic improvement, recurrences, and complications. SPSS was used to analyze the data and continuous variables were reported as mean + standard deviation and comparisons tested by paired t-tests. Statistically significance was predetermined to be p < 0.05.

Results: 75 patients with the mean age of 44.7 ± 12.5 years were involved in the study. Postoperative results showed a great improvement in SNOT-22 scores, which dropped to 28.7 (7.6) at 12 months (p < 0.001) compared to preoperative values of 62.4 (9.8). Nasal congestion resolved in 92 percent of the patients, hyposmia in 63 percent and headache in 62 percent. Recurrence was in 24 percent of the cases. Major complications were not reported Better symptomatic outcome was observed with extended FESS based on symptomatic relief compared to limitedFESS (p = 0.028). The quality-of-life scores showed better results which signify that FESS is effective in the reduction of symptoms and increases in day-to-day hactions in (CRS with NP) patients.

Conclusion: Functional Endoscopic Sinus surgery markedly relieves the symptoms, quality of life and olfactory process in patients of chronic rhino sinusitis with nasal polyps. Recurrences are problematic; however, thorough patient selection and prolonged incision are options to improve the prognosis. Techiest is safe with low complication rates, and offers sustained symptomatic relief, which supports its position as the surgery of first choice in a patient with medically refractory (CRS with NP) .