Efficacy of Endoscopic Middle-meatus Antrostomy in Chronic Maxillary rhinosinusitis. A Prospective

Introduction: Chronic maxillary sinusitis(CMS) significantly impacts quality of life, requiring effective interventions. Middle meatal antrostomy (MMA) is a widely performed surgical procedure, but its outcomes and complications need further evaluation. Aims and Objectives: This study aimed to assess the effectiveness of MMA in alleviating symptoms of chronic maxillary sinusitis and identify potential postoperative complications. Place and Duration of Study: The study was conducted at Khyber Teaching Hospital, Peshawar, from February 2022 to February 2024. Materials and Methods: A total of 120 consenting patients with chronic maxillary sinusitis meeting inclusion/exclusion criteria participated in this prospective study. Patients underwent clinical examinations, nasal endoscopy, and CT scans pre- and postoperatively. MMA was performed under local or general anesthesia using 0°, 30°, and 70° telescopes, back- biting forceps, and a micro debrider. Postoperative care included removal of nasal packing within 24-48 hours and follow-up assessments at 14 days and 3 months. Pre-and postoperative symptoms were compared, and complications were recorded. Data were analyzed using SPSS version 27. P value less than 0.05 considered significant. Results: Preoperative symptoms included nasal obstruction (87.5%), facial pain (75.8%), and headaches (63.3%). Postoperatively, nasal obstruction and facial pain decreased to 10.8% and 7.5%, respectively. Persistent headaches were noted in 5.8% of patients who initially reported them, while 71.6% experienced new-onset headaches. Postoperative complications included middle meatal synechiae (14.1%). Conclusions: MMA significantly alleviated preoperative symptoms of chronic maxillary sinusitis, particularly nasal obstruction, facial pain, and headaches. However, postoperative complications, such as new onset headaches and synechiae, underscore the need for careful patient management and further research to optimize outcomes.