European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026
Appropriate extent of endoscopic sinus surgery brings favorable therapeutic outcomes to chronic rhinosinusitis patients.
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Tran Thinh, Samuthpongtorn Jompol, Seresirikachorn Kachorn, Chitsuthipakorn Wirach, Hoang Minh P, Tran Luan V, Le Minh T Q, Anggraini Deasi, Wardani Retno S, Mohamad Sakinah, Abdullah Baharudin, Low Terese, Subramaniam Soma, Wungcharoen Prem, Chusakul Supinda, Snidvongs Kornkiat
Аннотация
PURPOSE: The optimal extent of endoscopic sinus surgery (ESS) for patients with chronic rhinosinusitis (CRS) remains undetermined. This study aimed to evaluate postoperative outcomes when the extent of ESS is concordant with the underlying pathophysiology.
METHODS: This study enrolled 116 patients with CRS scheduled for three categories of ESS: limited ESS, full-house ESS, and extended ESS. Concordant ESS was defined as (1) limited ESS performed for patients requiring ventilation and drainage and (2) either full-house ESS or extended ESS performed for patients requiring access for topical therapies. Postoperative outcomes included symptom visual analogue scale (VAS), the Sino-Nasal Outcome Test (SNOT-22), and endoscopic scores.
RESULTS: At one year, patients receiving concordant ESS achieved superior outcomes in symptom VAS (mean difference [MD] 1.38; 95% CI 0.62-2.15; P < 0.01), SNOT-22 (MD 22.73; 95% CI 15.46-30.00; P < 0.01), and endoscopic scores (MD 6.48; 95% CI 1.96-11.00; P < 0.01). When ESS was performed to improve ventilation and drainage, limited ESS and full-house ESS brought comparable outcomes. Limited ESS achieved better outcomes than extended ESS in SNOT-22 (MD - 21.05; 95% CI - 38.72 to - 3.37; P = 0.02). When ESS aimed to provide access for topical therapies, SNOT-22 was greater improved by full-house (MD 21.32; 95% CI 10.01-32.62; P < 0.01) and extended ESS (MD 26.16; 95% CI 14.85-37.46; P < 0.01) compared to limited ESS.
CONCLUSIONS: The extent of ESS should be tailored to the underlying pathophysiology. Limited and full-house ESS are appropriate to improve ventilation. Full-house and extended ESS provide better outcomes when access for topical therapies is required.
METHODS: This study enrolled 116 patients with CRS scheduled for three categories of ESS: limited ESS, full-house ESS, and extended ESS. Concordant ESS was defined as (1) limited ESS performed for patients requiring ventilation and drainage and (2) either full-house ESS or extended ESS performed for patients requiring access for topical therapies. Postoperative outcomes included symptom visual analogue scale (VAS), the Sino-Nasal Outcome Test (SNOT-22), and endoscopic scores.
RESULTS: At one year, patients receiving concordant ESS achieved superior outcomes in symptom VAS (mean difference [MD] 1.38; 95% CI 0.62-2.15; P < 0.01), SNOT-22 (MD 22.73; 95% CI 15.46-30.00; P < 0.01), and endoscopic scores (MD 6.48; 95% CI 1.96-11.00; P < 0.01). When ESS was performed to improve ventilation and drainage, limited ESS and full-house ESS brought comparable outcomes. Limited ESS achieved better outcomes than extended ESS in SNOT-22 (MD - 21.05; 95% CI - 38.72 to - 3.37; P = 0.02). When ESS aimed to provide access for topical therapies, SNOT-22 was greater improved by full-house (MD 21.32; 95% CI 10.01-32.62; P < 0.01) and extended ESS (MD 26.16; 95% CI 14.85-37.46; P < 0.01) compared to limited ESS.
CONCLUSIONS: The extent of ESS should be tailored to the underlying pathophysiology. Limited and full-house ESS are appropriate to improve ventilation. Full-house and extended ESS provide better outcomes when access for topical therapies is required.