Study on Effect of Functional Endoscopic Sinus Surgery on the Symptom Profile in Patients with Chronic Rhinosinusitis

Abstract Background: Chronic rhinosinusitis (CRS) is a common, debilitating inflammatory disease of the nose and paranasal sinuses lasting ≥12 weeks and impairing quality of life. Functional endoscopic sinus surgery (FESS) is recommended for patients refractory to adequate medical therapy to improve ventilation. Objectives: To evaluate changes in the symptom profile of CRS patients undergoing FESS at a tertiary care centre in Kolhapur, by comparing preoperative symptoms with postoperative outcomes up to six months. Methodology: This 18‑month hospital-based study included 50 CRS patients (allergic/infective) aged ≥12 years with symptoms ≥12 weeks and nonresponsive to ≥6 weeks of medical therapy. Exclusion criteria were age <12 years, gross deviated nasal septum, and prior nasal surgery. Eligible patients had ≥2 major symptoms or 1 major plus 2 minor symptoms. Symptoms were graded (0–3) preoperatively and followed postoperatively at serial intervals up to 6 months; analysis used SPSS v22.0. Results: Among 50 patients, most were aged 21–30 years (34%), followed by 31–40 years (30%); males predominated (62%). Symptoms most commonly persisted for 1–5 years (62%). Preoperatively, nasal obstruction was prominent (moderate 32, severe 6), facial pain/pressure was mainly mild-to-moderate (25 and 19), and anosmia was frequent (moderate 21, severe 10); headache was the leading severe minor symptom (severe 32). Postoperatively, core CRS symptoms improved progressively across follow-up. At 6 months, nasal obstruction showed the greatest improvement, with 80% reporting “much better” (p<0.001); facial pain/pressure and anosmia also improved significantly (70% and 68% “much better”, p<0.001). Post-nasal drip and nasal discharge demonstrated moderate improvement by 6 months (54% and 34% “much better”, respectively). In contrast, halitosis, dental pain, cough, and earache showed minimal/no improvement, suggesting possible non-sinonasal contributors. Conclusion: FESS provides significant symptomatic relief in medically refractory CRS, particularly for nasal obstruction, facial pain/pressure, anosmia, headache, post-nasal drip, and acute fever over six months. Limited improvement in halitosis, dental pain, cough, and earache highlights the need for evaluation of alternate causes and counselling.