The role of endoscopic sinus surgery in chronic sinonasal sarcoidosis

The aim of this study cas to define a role for endoscopic sinus surgery (ES S) in the treatment of chronic sinonasal sarcoidosis. All patients seen for sinonasal sarcoidosis in an otolaryngology practice in a tertiary care cen ter from 1991 to 2000 were reviewed. Of 86 patients, 6 were treated with ES S for an operative rate of 7%. Surgeries were performed on those patients w ith significant sinonasal anatomic blockage. This included nasal obstructio n from nasal polyposis and chronic. and recurrent acute sinusitis from gran ulomatous lesions of the ostiomeatal complex. Patients remained symptom fre e for years after surgery on a nasal steroid regimen. Endoscopic sinus surg ery is a viable treatment for those few patients with nasal obstruction or chronic sinusitis due to anatomic blockage from sinonasal sarcoidosis. Alth ough it does not eradicate the disease or prevent recurrence, it does marke dly improve quality of life by relieving severe symptoms and reducing the n eed for systemic steroids. This is the first study to advocate a role for s urgery in sinonasal sarcoidosis beyond biopsy and management of complicatio ns. Although it may not be the appropriate approach for every patient, ESS certainly should be considered in the treatment options.