Functional endoscopic dilatation of the sinuses: patient satisfaction, postoperative pain, and cost.
BACKGROUND
The purpose of this study was to determine how functional endoscopic dilatation of the sinuses (FEDS) compares with functional endoscopic sinus surgery (FESS) in a select group of patients with respect to (1) elimination of symptoms, (2) patient satisfaction, (3) postoperative narcotic use, and (4) cost. A retrospective study was performed of 70 patients with chronic rhinosinusitis who underwent FEDS or FESS as primary or revision treatment.


METHODS
Symptoms and satisfaction based on the Sino-Nasal Outcome Test (SNOT-20) questionnaires and global patient assessment, postoperative narcotic use, and costs were compared after 3-month follow-up.


RESULTS
SNOT-20 change scores indicated that both FEDS and FESS had clinically meaningful treatment responses. Patient satisfaction was higher and postoperative narcotics usage was less with FEDS. The cost for primary procedures was similar, whereas the cost for revision surgery using FEDS was considerably less. Turbinate lateralization and scarring was more common in the FEDS group, particularly early in the study. The incidence of recurrent sinus infections during the follow-up period was similar for both groups. Only one patient in the FEDS group required a repeat intervention within the short-term follow-up period.


CONCLUSIONS
Both FEDS and FESS resulted in significant improvement in SNOT-20 scores for selected patients with mild disease. Patient satisfaction and postoperative narcotic use of FEDS compare favorably with FESS. Cost of FEDS was comparable with FESS for primary procedures but was less than FESS for revision procedures. Long-term efficacy and final cost of FEDS remain to be addressed, taking into account the need for revision procedures after initial FEDS, by means of long-term studies and objective outcome measures.
Friedman
Michael
M
Department of Otolaryngology and Bronchoesophagology, Rush University Medical Center, Chicago, Illinois 60602, USA. hednnek@aol.com
Schalch
Paul
P
Lin
Hsin-Ching
HC
Mazloom
Narges
N
Neidich
Marci
M
Joseph
Ninos J
NJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D002404:Catheterization / Q000009:adverse effects / Q000191:economics*; D004106:Dilatation; D004724:Endoscopy / Q000009:adverse effects / Q000191:economics*; D005260:Female; D017721:Hospital Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain; D010256:Paranasal Sinuses / Q000601:surgery*; D017060:Patient Satisfaction; D012086:Reoperation; D012189:Retrospective Studies; D012852:Sinusitis / Q000601:surgery / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome