Postoperative management of endoscopic sinus surgery

Functional endoscopic sinus surgery has revolutionized our understanding and treatment of chronic rhinosinusitis. Optimal long-term patient outcomes result from a combination of treatment issues. Initial intraoperative techniques and decisions concerning the management of the middle turbinate and the need for middle meatal spacers or stents. Postoperative decisions include postsurgical cleaning schedules and treatment of synechiae or polyps that may contribute to unfavorable results. Finally, aggressive medical management of underlying inflammatory disease of the mucosa will permit rapid re-epithelialization and return of normal mucociliary function. This article reviews controversies surrounding these issues and provides the perspective of an experienced rhinology practice.