title: The effect of functional endoscopic sinus surgery on nasal spray distribution to the middle meatus in patients with rhinosinusitis.
abstract: BACKGROUND
  Because the principle behind functional endoscopic sinus surgery (FESS) recognizes the middle meatus as essential for the control of the disease, the effect of the operation in the distribution of drugs in the same area should be of similar importance. This study was designed to clarify whether nasal drug delivery is improved in patients after FESS. The study involved a prospective assessment within subject comparison. The subjects were 20 adult (>18 years old) patients on the waiting list for FESS. It was conducted within two teaching hospitals in the East of Scotland.
  
  
  METHODS
  A novel method was used, positioning a neurosurgical patty in the middle meatus and assessing blue dye nasal spray absorption on a 4-point scale.
  
  
  RESULTS
  A significant improvement was observed in the distribution of the indicator in the middle meatus postoperatively. Seventy percent of the patients showed improvement in the drug distribution after FESS. The median result for absorption score was 2 preoperatively (<50%) and 3 postoperatively (>50%). The difference was statistically significant (p<0.001).
  
  
  CONCLUSIONS
  The distribution of nasal drugs is improved in the middle meatus after FESS. This can have important clinical applications that can benefit patients in otolaryngology as well as other disciplines.
authors.affiliation: Department of Otolaryngology, University of Dundee, Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom. atsikoudas@nhs.net
authors.forename: Alexandros
authors.initials: A
authors.lastname: Tsikoudas
authors.forename: Martyn L
authors.initials: ML
authors.lastname: Barnes
authors.forename: Paul S
authors.initials: PS
authors.lastname: White
mesh_terms: D000042:Absorption; D000281:Administration, Intranasal; D000328:Adult; D000368:Aged; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008751:Methylene Blue / Q000008:administration & dosage; D008875:Middle Aged; D009666:Nose / Q000033:anatomy & histology / Q000187:drug effects / Q000601:surgery*; D011446:Prospective Studies; D012220:Rhinitis / Q000188:drug therapy* / Q000601:surgery; D012606:Scotland; D012852:Sinusitis / Q000188:drug therapy* / Q000601:surgery
chemical_list: D008751:Methylene Blue