title: Can FESS combined with submucosal resection (SMR)/septoplasty reduce revision rate?
abstract: OBJECTIVE
  Our study was designed to ascertain the outcomes of functional endoscopic sinus surgery (FESS) combined with submucosal resection (SMR)/septoplasty in reducing FESS revision rates.
  
  
  METHODS
  Retrospective population-based study.
  
  
  METHODS
  Academic tertiary medical center.
  
  
  METHODS
  By using the Taiwan Longitudinal Health Insurance Database, we obtained the patients who underwent FESS for chronic rhinosinusitis. These patients were divided into 2 groups: the control group (FESS alone) and the study group (FESS combined with SMR). The primary outcome was the revision operative rate.
  
  
  RESULTS
  In total, 4484 patients who had undergone FESS were recruited into this study. The number of patients who underwent revision FESS was 528 (11.78%). In our sample, 80.45% of patients received FESS alone, whereas 19.54% of the patients underwent concurrent SMR/septoplasty during FESS. There are more female patients and older patients in the control group than in the study group. The revision rates of these 2 groups were significantly different (12.36% vs 9.36%, respectively; P = .016). Moreover, logistic regression analysis came out that patients in the control group had a higher revision rates than those in the study group. Male patients and younger patients were found to have higher revision rates. In addition, patients with asthma or allergic rhinitis had higher revision rates compared with those patients without these 2 comorbidities.
  
  
  CONCLUSIONS
  This study showed an association between FESS combined with concurrent SMR/septoplasty and less incidence of revision rate of FESS. Patients with asthma or allergic rhinitis have an increased risk of requiring more revision surgeries after FESS.
authors.affiliation: Departments of Otolaryngology, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Chan-Chi
authors.initials: CC
authors.lastname: Chang
authors.affiliation: Departments of Otolaryngology, China Medical University Hospital, Taichung, Taiwan College of Medicine, China Medical University, Taichung, Taiwan d3485@mail.cmuh.org.tw.
authors.forename: Chih-Jaan
authors.initials: CJ
authors.lastname: Tai
authors.affiliation: Departments of Otolaryngology, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Teik-Ying
authors.initials: TY
authors.lastname: Ng
authors.affiliation: Departments of Otolaryngology, China Medical University Hospital, Taichung, Taiwan College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Yung-An
authors.initials: YA
authors.lastname: Tsou
authors.affiliation: Departments of Otolaryngology, China Medical University Hospital, Taichung, Taiwan College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Ming-Hsui
authors.initials: MH
authors.lastname: Tsai
mesh_terms: D000328:Adult; D002908:Chronic Disease; D004724:Endoscopy; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009300:Nasal Septum / Q000473:pathology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D012220:Rhinitis / Q000150:complications / Q000473:pathology / Q000601:surgery*; D012225:Rhinoplasty; D012852:Sinusitis / Q000150:complications / Q000473:pathology / Q000601:surgery*; D013624:Taiwan; D016896:Treatment Outcome
keywords: SMR; allergic rhinitis; asthma; deviated nasal septum; revision FESS; septoplasty