title: [Prolonged healing process after endonasal nasal sinus surgery. Gastroesophageal reflux as a cause?].
abstract: BACKGROUND
  The healing process after functional endoscopic sinus surgery (FESS) normally takes weeks to months under an intensive therapy regime. Occasionally, symptomatic failures and local problems occur despite extensive follow-up treatment.
  
  
  METHODS
  Over a 3-year period 900 patients underwent FESS in our department. Of these patients, 79 were found with no tendency toward improvement of symptoms and signs more than 3 weeks after the operation. Nasal obstruction, frontal headache, and postnasal drainage were evaluated to be the frequent postoperative complaints. Scarring of the middle meatal antrotomy and the ethmoid, inflammatory granulation, and early recurrence of polyps occurred as the local problems. Historical factors and clinical signs of gastroesophageal or laryngopharyngeal reflux were examined in this group. Afterwards, proton pump inhibitors were prescribed on a trial basis.
  
  
  RESULTS
  Historical clues of reflux were reported by 30 patients only. However, clinical signs of a reflux were found in 66 cases. Rhinological symptoms and signs were improved in 60 patients following the application of proton pump inhibitors over 2 weeks.
  
  
  CONCLUSIONS
  Our results support earlier experiences reported in the literature. Laryngopharyngeal reflux could be a factor altering the healing process after FESS.
authors.affiliation: MediClin AG, HNO-Klinik der Müritz-Klinikum GmbH Waren, Waren. detlef.kleemann@mueritz-klinikum.de
authors.forename: D
authors.initials: D
authors.lastname: Kleemann
authors.forename: S
authors.initials: S
authors.lastname: Nofz
authors.forename: I
authors.initials: I
authors.lastname: Plank
authors.forename: A
authors.initials: A
authors.lastname: Schlottmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015984:Causality; D015897:Comorbidity; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000453:epidemiology*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000706:statistics & numerical data*; D010256:Paranasal Sinuses / Q000601:surgery*; D015995:Prevalence; D020127:Recovery of Function; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012852:Sinusitis / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D013997:Time Factors; D014945:Wound Healing