Effectiveness of Full House Revision Endoscopic Sinus Surgery in Recurrent Chronic Rhinosinusitis: Results from a Prospective Cohort Study

Objective: To evaluate the effectiveness of full-house revision functional endoscopic sinus surgery (FESS) in patients with recurrent chronic rhinosinusitis (CRS) who had previously undergone sinus surgeries. Methods: This prospective study was carried out at the Otorhinolaryngology – Head & Neck Surgery Center in Sulaymaniyah Teaching Hospital and Zhian Private Hospital between January 2019 and March 2020. A total of 21 patients with recurrent CRS, each having undergone at least one previous sinus surgery, were enrolled to undergo revision full-house FESS. The effectiveness of the surgery was assessed using both subjective and objective outcome measures. Subjective evaluations included the Sino-Nasal Outcome Test (SNOT-22) and the Smell Identification Test (SIT) utilizing 16 Sniffin’ Sticks. Objective assessments included the Modified Lund-Kennedy (LK) endoscopic scoring system and the Lund-Mackay (LM) scoring system based on computed tomography scans. Evaluations were conducted preoperatively and postoperatively at 1, 3, and 6 months, with LM scores recorded at baseline and again at the 6-month follow-up. Results: The study cohort consisted of 21 patients, including 11 females and 10 males, with a mean age of 41.67 ± 11.93 years. Preoperative mean scores were as follows: SNOT-22 (48.10 ± 4.40), LK (4.10 ± 0.26), LM (10.48 ± 1.62), and SIT (8.00 ± 4.06). Statistically significant improvements were observed postoperatively across all parameters (P = 0.001). However, no significant differences in outcomes were identified based on the duration of follow-up or the number of previous sinus surgeries, specifically for the SNOT-22, LK, and LM scores. Conclusion: Revision full-house FESS resulted in significant improvement in both subjective and objective outcome measures over a 6-month follow-up period. These findings suggest that this surgical approach is an effective and reliable option for managing patients with recurrent CRS, offering notable enhancement in quality of life.