Revolutionizing chronic rhinosinusitis treatment with functional endoscopic sinus surgery: Insights from a low–middle income country

Chronic rhinosinusitis is a common condition that significantly affects quality of life, and functional endoscopic sinus surgery (FESS) has emerged as a widely used, minimally invasive procedure for its treatment. This retrospective study aimed to analyze the symptom patterns and variations in surgical approaches during FESS for treating chronic rhinosinusitis. The study included 110 patients who underwent FESS at a tertiary care center of eastern Nepal between January 2021 and December 2022. Of the participants, 51.81% were male, and 48.18% were female, with a mean age of 32.92 years for males and 29.03 years for females. Preoperative assessments included nasal endoscopy and computed tomography scans, followed by detailed counseling on surgery and potential complications. The most common symptom among the patients was nasal obstruction, while anosmia was the least prevalent. Nasal polyposis was diagnosed in 61 patients. The surgical approaches varied: 27.27% of patients underwent full house FESS, 48.18% had medial maxillary antrostomy with spheno-ethmoidectomy, and 24.54% had medial maxillary antrostomy with ethmoidectomy. Additionally, 93.63% of patients had endoscopic septoplasty, and 37.27% underwent turbinate reduction. Follow-ups were conducted at 3 months, 6 months, and 1 year, with outcomes evaluated through nasal endoscopy. The study reported minimal complications, including 1 case of minor bleeding and 5 cases of middle turbinate lateralization. The findings suggest that FESS is an effective treatment for chronic rhinosinusitis, with precise sinus opening, polyp removal, and mucosal preservation, combined with appropriate surgical planning, significantly improving symptoms and reducing the risk of recurrence.