Ear Nose & Throat / Endoscopic Sirius Surgery.


Functional endoscopic sinus surgery (FESS) is the mainstay in the surgical treatment of sinusitis and nasal polyps, including bacterial, fungal, recurrent acute, and chronic sinus problems. Ample research supports its record of safety and success. FESS is a relatively recent surgical procedure that uses nasal endoscopes (using Hopkins rod lens technology) through the nostrils to avoid cutting the skin. FESS came into existence through the pioneering work of Drs. Messerklinger and Stamberger (Graz, Austria). Other surgeons have made additional contributions (first published in USA by Kennedy in 1985).[1] A Cochrane review in 2006, based on three randomized control trials(Fairley 1993, Hartog 1997, and Ragab 2004) concluded that there was no significant difference in cure rates comparing FESS to other treatment methods. A meta-analysis of these three studies was not used as the studies did not have a single disease staging system, a single FESS procedure or uniform outcomes measures. Fairley 1993 found no significant difference between FESS and inferior meatal antrostomy in regards to symptoms score (weighted mean difference (WMD) 1.37, p=0.6). Hartog 1997 found no statistically significant difference in cure rates at 1 year when comparing FESS to nasal irrigation alone (odds ratio 1.63, P = 0.35). Ragab 2004 found no significant difference in total symptoms score at one year between FESS and medical treatment aloneWMD 1.20, P = 0.86). Hartog 1997 found a relapse rate of 2.4% in FESS and sinus irrigation group and 5.6% relapse rate in sinus irrigation only group (RRR=0.571, NNT = 32). The other studies did not mention relapse rate