Assessment of the quality of life of patients with recalcitrant chronic maxillary sinusitis after revision endoscopic sinus surgery: an analysis of early and long-term outcomes

Objective. To investigate quality of life of patients with recalcitrant chronic maxillary sinusitis (CMS) after revision endoscopic maxillary antrostomy in the early and long-term postoperative periods. Patients and methods. This study involved 163 patients divided into 3 clinical groups: Group 1 included patients with previously operated recurrent CMS; Group 2 comprised patients with CMS and concomitant polysinusitis; Group 3 consisted of patients undergoing primary surgery for CMS. All patients underwent endoscopic maxillary antrostomy via the natural ostium with uncinectomy and uniting the natural and accessory ostia. Furthermore, in previously operated patients, the inferior meatal antrostomy was closed with a mucoperiosteal flap. Quality of life was assessed before surgery and at 1 and 6 months postoperatively using the SNOT-22 questionnaire. Results. Prior to treatment, patients exhibited severe nasal obstruction, rhinorrhea, postnasal drip, and olfactory dysfunction, which significantly impaired their quality of life. A statistically significant reduction of the severity of all analyzed symptoms was observed in all 3 groups 1 month after surgery. The most pronounced improvement was noted in facial pain; in addition, thick nasal discharge and sleep disturbances were completely resolved. The achieved clinical effect was maintained in the majority of patients across all groups 6 months after surgery. The best long-term results were observed in patients undergoing primary surgery for CMS, the results were also stable also in patients with polysinusitis. However, in patients with recurrent CMS after previous operations, despite a significant reduction in the severity of nasal symptoms, sinus discomfort and concentration on their condition recurred as early as 6 months after revision surgery. Conclusion. Endoscopic revision surgery for recurrent maxillary sinusitis demonstrated good short- and long-term results with improved quality of life.