FUNCTIONAL ENDOSCOPIC SINUS SURGERY IN PATIENTS WITH NORMAL COMPUTED-TOMOGRAPHY SCANS

Eighteen patients were operated on by functional endoscopic sinus surg ery who had no ostiomeatal unit obstruction on computed tomography sca n and had unremarkable paranasal sinuses. These patients also had no a pparent ostiomeatal unit obstruction on diagnostic nasal endoscopy. Da ta were collected on these patients regarding the impact of very limit ed functional endoscopic sinus surgery on their principal complaint of recurrent sinusitis with facial pain/headache thought to be of sinoge nic origin. Sixteen patients (88.9%) had a reduction in the number of sinus infections requiring antibiotic therapy. This reduction was sign ificant at p < 0.0001. Twelve of 14 patients whose facial pain/headach e was believed to be of sinogenic origin had a significant reduction i n severity (95% confidence interval, 49.2% to 95.3%). We discuss the r ole of reversible nasal mucosal disease in the pathophysiology of recu rrent rhinosinusitis in this patient population. This was a very small , select group of patients who had specific complaints and had had med ical treatment failures. This therapy is not recommended for every pat ient, but only a select few with classic complaints of sinus headaches or recurrent sinusitis and negative computed tomography scans.