Advancements In The Surgical Management Of Chronic Rhinosinusitis:A Prospective Study Of Fess And Balloon Sinuplasty

Abstract

Background: Chronic rhinosinusitis (CRS) exists as a global problem which causes enduring sinonasal inflammation among millions of affected individuals. Patients show symptoms including nasal congestion whereas they also feel facial pain together with reduced mucociliary clearance capabilities. The standard medical interventions for CRS treatment include corticosteroids with nasal irrigation and antibiotic administration. The failure of medical treatment leads to evaluations of Functional Endoscopic Sinus Surgery (FESS) and Balloon Sinuplasty (BS) as surgical procedures. The approach of FESS removes tissue for better sinus drainage while BS requires no removal through its dilation method. An essential evaluation of these medical approaches is needed to achieve optimal patient results.

Objectives:  The study  targets a comparison of FESS and BS by assessing their effectiveness and complications and postoperative results. This study determines appropriate criteria for patient selection between FESS and BS by combining disease severity with anatomical variations.

Study design: A prospective study.

Place and duration of study. this study conducted in department of ENT Kabir Medical college Peshawar from jan 2022 to july 2022

Methodology:  The prospective comparative Study investigated CRS medical nonresponder patients through 200 subjects. The clinical requirements determined patient assignment either to FESS or BS procedures. The study  teams obtained demographic information, symptom severity scores and surgery-related data and postoperative complication data from 200 CRS patients. Statistical analysis included standard deviation calculation and determination of p-values for comparing significance. Study  also determined mean patient age. The study retrieved data from PubMed in combination with Cochrane Library and clinical trial registries.

Results:  The study  sample involved 200 patients who averaged 45.6 years old (± 12.3) in age. The patients in the FESS treatment group reached their mean age of 46.1 years (with 11.8 points of variation) and those in the BS group had an average age of 44.9 years (± 12.7). Age differences between the two groups received a p-value of 0.37 which shows the results do not demonstrate any meaningful differences. Symptoms improved by 85% through FESS thus proving better than BS improvements at 70% (p = 0.02). Postoperative complications emerged in 12% of patients who underwent FESS procedures while the incidence of complications in patients receiving BS treatment reached 5% according to statistical results (p = 0.04). The majority of patients in the BS treatment group recovered within seven days yet those in the FESS group needed fourteen days (p = 0.01 for the statistical difference). Three percent of patients who received FESS needed revision treatment contrary to eight percent of those undergoing BS treatment (p = 0.05).

Conclusion: The treatment of CRS can effectively be conducted through FESS as well as BS. The superior choice for severe and polypoid conditions remains FESS yet BS provides a minimally invasive option for people with mild to moderate CRS. The selection process of patients for treatment should consider their disease extent together with their anatomical conditions along with personal treatment preferences. Long-term assessment studies need to happen to improve indications and maximize postoperative results.