title: Endoscopic sinus surgery for chronic rhinosinusitis in patients previously treated for sinonasal malignancy.
abstract: OBJECTIVE
  Patients with a history of sinonasal malignancy can develop chronic rhinosinusitis (CRS) as a consequence of their oncologic treatment. Some patients will fail medical management and require endoscopic sinus surgery (ESS). This study reviews the use of ESS in the management of CRS in patients previously treated for sinonasal malignancy.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  All patients with a history of sinonasal malignancy who developed CRS and underwent ESS were reviewed. Preoperative and postoperative imaging and symptoms were collected. Major complications (bleeding, orbital injury, and cerebrospinal fluid leak) and minor complications (adhesion formation) and postoperative healing were reviewed.
  
  
  RESULTS
  Eighteen patients were identified. All patients presented with symptoms of CRS and sinonasal crusting. Additionally, five patients presented with recurrent facial cellulitis, and six patients had mucoceles. No major complications were encountered. Postoperatively, all patients reported a subjective improvement in their sinonasal symptoms. Comparison of pre- and post-ESS imaging revealed a significant improvement in Lund-Mackay scores after ESS (P < 0.001) from 12.8 (range 5-22) to 7 (range). Despite symptomatic improvement, all patients continued to have nasal crusting. All patients who initially presented with recurrent facial cellulitis had no further episodes after ESS. None of the endoscopically drained mucoceles recurred.
  
  
  CONCLUSIONS
  For patients previously treated for sinonasal malignancy with refractory CRS, ESS appears to be a safe and effective treatment option. ESS in these patients results in subjective improvement in sinonasal symptoms as well as objective improvement in radiographic CRS disease burden, although sinonasal crusting will likely not resolve.
  
  
  METHODS
  4.
authors: Department of Otolaryngology, Massachusetts Eye and Ear Infirmary.|Department of Otology and Laryngology.
authors: Stacey T
authors: ST
authors: Gray
authors: Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors: Peter M
authors: PM
authors: Sadow
authors: Department of Otolaryngology, Massachusetts Eye and Ear Infirmary.|Department of Otology and Laryngology.
authors: Derrick T
authors: DT
authors: Lin
authors: Department of Otolaryngology, Massachusetts Eye and Ear Infirmary.|Department of Otology and Laryngology.
authors: Ahmad R
authors: AR
authors: Sedaghat
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003131:Combined Modality Therapy; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009669:Nose Neoplasms / Q000150:complications / Q000628:therapy*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D010255:Paranasal Sinus Neoplasms / Q000150:complications / Q000628:therapy*; D012189:Retrospective Studies; D012220:Rhinitis / Q000150:complications / Q000601:surgery*; D012852:Sinusitis / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Chronic rhinosinusitis; complications; endoscopic sinus surgery; sinonasal malignancy