Vol. 99  No. May 2006

Revision Endoscopic Sinus Surgery 
for Chronic Rhinosinusitis

Masako Masuda, Tatsuya Honda and Eiji Yumoto
(Kumamoto University)


Endoscopic sinus surgery (ESS) has become one of the most common surgical procedures for otolaryngologists. Published success rates are very good, but there have been some unsuccessful cases requiring revision surgery. We investigated 29 patients who underwent revision ESS.
Most patients were found to have an obstructed middle nasal meatus with polyps or scaring. Revision ESS has been performed with attention to widen the middle nasal meatus, especially to prevent lateralization of the middle turbinate. We attempted intentional adhesion of the middle turbinate and nasal septum in some cases. All patients were followed-up for more than six months after revision surgery, and most patients underwent postoperative computed tomography (CT).
There was no case of postoperative obstruction of the middle nasal meatus. Success rate by CT examination was 58.5%. Reasons for revision surgery failure were the recurrence of massive polyps (14.6%) or scarring at the frontal recess following recurrent obstruction (26.8%).
The problem of middle nasal meatus obstruction was overcome by revision surgery. As a result, the recurrence of polyps could be controlled by postoperative care in half of the cases.

Key words : revision endoscopic sinus surgery, middle nasal meatus, computed tomography

第99巻5号 目次   Vol.99 No.5 contents