Article
Prognostic factors in endoscopic surgery of chronic maxillary sinusitis
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Published: | April 4, 2012 |
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Introduction: This article evaluates the impact of risk factors on postoperative outcomes of patients operated for chronic maxillary rhinogenous sinusitis using FESS.
Methods: The study was conducted in a retrospective nonrandomized manner and included patients operated endocopically in ENT Clinic Cluj-Napoca of Cluj County Clinical Hospital between 1998-2004 for chronic rhinogenous maxillary sinusitis. Ten parameters were studied: age, gender, smoking, allergy, asthma, non-steroidal antiinflamatory drugs intolerance, recurrent sinusitis, previous sinus surgery, resection of head of middle turbinate, maxillary mucosa endoscopic status.
Results: The group included 137 patients, 81 males and 56 females. Age ranged from 12 and 67 years, with an average of 43.1 years. 35 patients had allergy (25.54%), 23 (16.78%) asthma, 8 (5.83%) intolerance to aspirin and NSAIDs. Smoking occurred in 31 patients(23.62%, history of episodes of sinusitis and antibiotic treatment presented 73 (53.28%. Rhinosinusal surgery history was found in 30 patients (21.89%). Resection of the head of the middle turbinate was performed in 27 cases (19.70%). Endoscopic sinus mucosa scores were: 0 - 14 cases (10.21%), I - 28 (20.43%), II - 26 (18.97%), III - 34 (24.81%), IV - 35 cases (25.54%). Recurrence was recorded in 8 cases (5.83%). In multivariate analysis smoking was found as an independent predictive factor of postoperative recurrence, p=0.0017. The favorable effect of middle turbinate resection was confirmed as independent by the multivariate analysis, p= 0.0029.
Conclusions: By studying the prognostic factors will be able to obtain a more accurate preoperative documentation, which will facilitate better identification of groups of patients who are susceptible of recurrence.