title: Effectiveness of extensive sinus surgery with post-operative medical management for chronic rhinosinusitis.
abstract: OBJECTIVE
  To prospectively assess treatment outcomes of chronic rhinosinusitis patients undergoing functional endoscopic sinus surgery and post-operative medical treatment over a prolonged follow-up period.
  
  
  METHODS
  Patients undergoing functional endoscopic sinus surgery in the tertiary referral practice of a single surgeon were studied prospectively. Symptoms were scored by patients pre-operatively and over a minimum follow-up period of 12 months.
  
  
  RESULTS
  The study comprised 200 non-consecutive patients. The median pre-operative symptom score was 16 (out of a maximum of 25) (95 per cent confidence interval = 15 to 17). Symptom scores reduced to a median of 7 (95 per cent confidence interval = 6 to 8) after 12 months of follow up (p < 0.0001). The median symptom score improved for all symptoms and across all patient subgroups.
  
  
  CONCLUSIONS
  Extensive functional endoscopic sinus surgery offers significant and durable symptom improvement in patients with chronic rhinosinusitis refractory to medical treatment. This improvement extends to all patient subgroups. Prolonged medical therapy is recommended after functional endoscopic sinus surgery.
authors.affiliation: Department of Surgery,University of Auckland,Auckland,New Zealand.
authors.forename: A J
authors.initials: AJ
authors.lastname: Wood
authors.affiliation: Waitemata District Health Board,Auckland,New Zealand.
authors.forename: L
authors.initials: L
authors.lastname: Zhou
authors.affiliation: Department of Surgery,University of Auckland,Auckland,New Zealand.
authors.forename: S
authors.initials: S
authors.lastname: Wilkinson
authors.affiliation: Department of Surgery,University of Auckland,Auckland,New Zealand.
authors.forename: R G
authors.initials: RG
authors.lastname: Douglas
mesh_terms: D016063:Blood Loss, Surgical / Q000517:prevention & control; D002908:Chronic Disease; D004724:Endoscopy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D012086:Reoperation; D012220:Rhinitis / Q000601:surgery*; D012225:Rhinoplasty / Q000379:methods; D012852:Sinusitis / Q000601:surgery*; D016896:Treatment Outcome
keywords: Adult; Chronic Disease; Follow-Up Studies; Humans; Nasal Polyps; Prospective Studies; Sinusitis; Treatment Outcome