title: Revision endoscopic sinonasal surgery.
abstract: OBJECTIVE
  Endoscopic sinonasal surgery is the procedure of choice in the treatment of chronic rhinosinusitis and sinonasal polyposis refractory to medical treatment, with high rates of success (76% to 97.5%). However, 2.5%-24% of those patients will require revision surgery (RESS). In this study, we present the clinical, anatomical, radiological and histological features of patients receiving RESS in our centre during a 3-year period.
  
  
  METHODS
  A retrospective review of clinical, anatomical, radiological and histopathological data of patients receiving revision endoscopic sinonasal surgery between 2012 and 2014 was carried out.
  
  
  RESULTS
  From 299 surgery procedures performed, 27 (9%) were revision surgeries. The mean patient age was 46 years, with a male/female ratio of 1.4/1. The most frequent preoperative and postoperative diagnosis was chronic polypoid rhinosinusitis. The mean time since the previous surgery was 6.1 years, with 11.9 months of mean follow-up since that surgery. Stenotic antrostomy was found during revision in 81.5% of the patients and incomplete anterior ethmoidectomy and persistent uncinate process, in 59.3%. In radiology, 70.4% of patients had persistent anterior ethmoidal cells. Antrostomy or widening of antrostomy was performed in 96.3% of cases and anterior ethmoidectomy or completion of it was performed in 66.7%.
  
  
  CONCLUSIONS
  Polyps, stenotic antrostomy and incomplete ethmoidectomy were the most frequent causes of revision surgery, in concordance with the procedures performed. The patients had long periods of time without follow-up between surgeries. Further investigation is necessary to generate measures to reduce the number of revision surgeries.
authors.affiliation: Universidad de Chile, Santiago, Chile.
authors.forename: Pablo
authors.initials: P
authors.lastname: Cantillano
authors.affiliation: Departamento de Otorrinolaringología, Hospital Clínico Universidad de Chile, Santiago, Chile.
authors.forename: Fabián
authors.initials: F
authors.lastname: Rubio
authors.affiliation: Departamento de Otorrinolaringología, Hospital Clínico Universidad de Chile, Santiago, Chile.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Naser
authors.affiliation: Departamento de Otorrinolaringología, Hospital Clínico Universidad de Chile, Santiago, Chile. Electronic address: rnazars@gmail.com.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Nazar
mesh_terms: D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015508:Nasal Obstruction / Q000209:etiology / Q000601:surgery; D009298:Nasal Polyps / Q000000981:diagnostic imaging / Q000601:surgery; D018308:Papilloma, Inverted / Q000000981:diagnostic imaging / Q000601:surgery; D010254:Paranasal Sinus Diseases / Q000000981:diagnostic imaging / Q000601:surgery; D010255:Paranasal Sinus Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D011127:Polyps / Q000000981:diagnostic imaging / Q000601:surgery; D012086:Reoperation / Q000379:methods*; D012189:Retrospective Studies; D012220:Rhinitis / Q000000981:diagnostic imaging / Q000601:surgery; D012852:Sinusitis / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed
keywords: Cirugía endoscópica nasosinusal; Endoscopia; Endoscopic sinonasal surgery; Endoscopy; Poliposis; Polyposis; Sinusitis