title: Long-term outcomes of endoscopic maxillary mega-antrostomy for refractory chronic maxillary sinusitis.
abstract: BACKGROUND
  Endoscopic maxillary mega-antrostomy (EMMA) is a revision surgical procedure for recalcitrant maxillary sinusitis in which medical therapy and endoscopic antrostomy have been unsuccessful. In 2008 our group published favorable outcomes of EMMA in 28 patients with relatively short follow-up and nonvalidated outcome measures. This study reports an update of long-term outcomes of this same cohort, as well as outcomes of an interval cohort of 94 patients using validated outcome measures.
  
  
  METHODS
  Retrospective review was performed for 122 patients (163 sides) who underwent EMMA between 2005 and 2013. For the original 2008 cohort, the original questionnaire from 2008 was readministered by telephone interview. For the interval cohort, preoperative and postoperative SNOT-22 symptom scores and modified Lund-Kennedy endoscopic scores were compared.
  
  
  RESULTS
  The original 2008 cohort of 28 patients, now with a mean follow-up period of 6.9 years, demonstrated sustained improvement of symptoms. The outcomes were statistically comparable to the 2008 study, with 72.4% reporting complete or significant improvement, 27.6% reporting partial improvement, and 0% reporting worsening.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA; Department of Otolaryngology, Clinics Hospital, School of Medicine, University of São Paulo, São Paulo, Brazil.
authors.forename: Milena L
authors.initials: ML
authors.lastname: Costa
authors.forename: Alkis J
authors.initials: AJ
authors.lastname: Psaltis
authors.forename: Jayakar V
authors.initials: JV
authors.lastname: Nayak
authors.forename: Peter H
authors.initials: PH
authors.lastname: Hwang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D015331:Cohort Studies; D004351:Drug Resistance; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000000981:diagnostic imaging* / Q000601:surgery; D015523:Maxillary Sinusitis / Q000175:diagnosis* / Q000601:surgery; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
keywords: chronic rhinosinusitis; cystic fibrosis; endoscopic medial maxillectomy; endoscopic sinus surgery; maxillary sinusitis; mega-antrostomy; refractory sinusitis