title: Refractory chronic sinusitis: evaluation of symptom improvement after Denker's procedure.
abstract: OBJECTIVE
  Although there is ample literature describing various aspects of functional endoscopic sinus surgery (FESS) in relationship to its success rates, very little has been reported regarding possibilities in case of recurrent failure. We investigated subjective results of Denker's procedure used as a last resort for refractory chronic rhinosinusitis/polyposis.
  
  
  METHODS
  A retrospective questionnaire-based study of 82 patients who underwent Denker's procedure between 1986 and 1997 at the Erasmus University Medical Center, The Netherlands, was conducted.
  
  
  RESULTS
  Eighty-four percent of patients reported reduction of overall symptomatology. A significant reduction of nasal obstruction, headache, feeling of fullness, post-nasal drip, rhinorrhoea, facial pain, dental pain, and coughing was reported. In addition, symptoms of lower airway inflammation did improve significantly in asthmatic patients.
  
  
  CONCLUSIONS
  These data suggest that radical surgery using Denker's approach should be considered in selected cases after recurrent failure of functional sinus surgery.
  
  
  CONCLUSIONS
  A prospective study is warranted to validate this approach for refractory chronic rhinosinusitis.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors.forename: V B
authors.initials: VB
authors.lastname: Wreesmann
authors.forename: W J
authors.initials: WJ
authors.lastname: Fokkens
authors.forename: P P
authors.initials: PP
authors.lastname: Knegt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013506:Otologic Surgical Procedures; D012086:Reoperation; D012189:Retrospective Studies; D012852:Sinusitis / Q000601:surgery*; D016896:Treatment Outcome