ANALYSIS OF PAIN AND ENDOSCOPIC SINUS SURGERY FOR SINUSITIS

This prospective clinical descriptive study was designed to see whethe r patients who had endoscopic sinus surgery for sinusitis had relief o f pain, and whether they had new pain postoperatively. The sample was 252 consecutive patients who underwent endoscopic sinus surgery after presenting with inflammatory sinus disorders meeting specific clinical definitions of sinusitis and criteria for surgically treatable sinus disorders developed by the treating surgeon. Of the 252 consecutive en doscopic sinus surgery patients, 106 (42%) had no preoperative pain an d 146 (58%) patients had preoperative sinus pain. At 6- to 12-month po stoperative evaluations, patients with no preoperative pain did not de velop any new postoperative pain. Among the 146 patients with preopera tive pain, 82 (56%) had no pain, residual symptoms, or further sequela e, and were considered cured; 42 (29%) reported a marked improvement o f pain or discomfort; 9 (6%) had the same degree of pain or discomfort as before; 3 (2%) reported worse pain or discomfort; and 10 (7%) repo rted new pain or discomfort. These results suggest that the applicatio n of consistent definitions and clinical criteria for various forms of surgically treatable sinusitis will more likely predict improvement o f pain and discomfort following surgical treatment. The risk of develo ping new pain and discomfort following endoscopic sinus surgery in ind ividuals without preoperative pain or discomfort is negligible. The ri sk of worsening pain or new pain was less than 10% in patients with pr eoperative pain. Ongoing efforts such as the International Conference on Sinus Disease in the development of consistent terminology, staging , and therapy, and future modifications from additional clinical exper ience, should result in more predictable and effective care in the sur gical treatment for pain of sinus disease.