Endoscopic versus conventional surgery of chronic rhinosinusitis - A clinical study in Al-Sadder Teaching Hospital, Missan, Iraq

Background. Endoscopic sinus surgery is a well-established surgical procedure for the treatment of chronic rhinosinusitis that does not respond to medical treatment. Conventional surgery is still performed by surgeons. Therefore, it is worthwhile to study and evaluate both methods. Objective. To assess the effectiveness of endoscopic sinus surgery versus conventional surgery for the treatment of chronic maxillary sinusitis. Method. A prospective comparative study of 45 cases of chronic maxillary sinusitis refractory to medical treatment involving patients of different ages and sexes was conducted from January to December 2023 at the AL-Sadder Hospital. Approximately 25 patients underwent conventional surgery, and 20 underwent endoscopic sinus surgery. All patients underwent full history taking, clinical and endoscopic examinations, radiological evaluation, and postoperative follow-up for six months. Results. The male-to-female ratio was 1.5:1. The main complaints were nasal obstruction (62.2%), facial pain (13%), nasal discharge (11.1%), and headaches (8.9%). A total of 45 cases suffering from chronic rhinosinusitis uncured by medical treatment were included in the study. Twenty-five patients were treated with conventional surgery, while 20 were treated with endoscopic surgery. The most common finding was congested mucosa (88.9%), followed by a hypertrophied inferior turbinate (77.8%). Mucopus in the osteomeatal complex (44.4%), polyps (17.8%), and large middle turbinate (11.1%) were the most common endoscopic findings. Conclusion. Chronic sinusitis mainly affects young age groups; nasal obstruction is the most common presentation, followed by facial pain, nasal discharge, and headaches. Conventional surgery is effective when the predisposing factor for sinusitis is septal deviation, whereas endoscopic surgery is effective in cases of osteomeatal unit obstruction.