Functional vs. radical maxillary surgery. Failures after functional endoscopic sinus surgery.

Randomized FES or Caldwell-Luc (C-L) operations were performed in 150 patients suffering from chronic maxillary sinusitis during 1987-1989. Follow-up examination was done for 143 patients (95%) 1 year postoperatively. Although 15 patients had already deceased, questionnaires were obtained from 128 patients (85%) 5-9 years after operation. One year after surgery 51% of the C-L patients and 77% of the FES patients reported no symptoms or distinct improvement in their global symptoms, whereas 5-9 years postoperatively 82% of the C-L and 76% of the FES patients reported this outcome, respectively. Thirteen C-L operated patients (18%) and 14 FES patients (20%) have been reoperated during 7-9 years follow-up. In most cases revision surgery was done for polyposis or maxillary sinusitis. In the long term, altogether 21 patients (28%), including 14 reoperated patients, were failures after FES. These included also 4 patients with global symptoms unchanged at late inquiry and 3 other patients, though getting better, reported unwillingness for FES operation if they had known the result beforehand.