Nasal polyps and chronic sinusitis are well-recognized clinical syndrome affecting patients of all ages and gender. Functional endoscopic sinus surgery (FESS) has now become a well-established strategy, comprising several techniques, for the treatment of above conditions refractory to medical treatment for the last 2-3 decades.
But having done few hundred cases of both Caldwell luc and FESS, there are more and more relapse cases in the FESS category. Complication rates are equal in both groups.
For the last 10 years more and more Re-Do FESS cases are increasing, not only mine but cases done by senior surgeons elsewhere who have many years of experience.
A combination of Caldwell luc and FESS is one I prefer to get maximum result and less relapse. More randomized controlled trials comparing FESS with Caldwell luc with long-term follow up, are required.
In case of acute sinusitis, Antral lavage-Sinus irrigation followed by systemic antibiotics given in proper dose is the best regime. There is a dislike for antral lavage in recent years.
Conclusion
If not done properly, any surgery can be a failure but more so in the case of FESS.
