4Case Study: 55 yo man 3 episodes of acute sinusitis since last winter Treated with antibioticsResolution of acute sxcontinues to have pressure “sinus” headache, nasal congestion, poor smell, and intermittent rhinorrhea.
25“Sinus headache” Headache is complicated Multifactorial! Sinus headache/pain does NOT mean sinusitisMUST have proper evaluation
26FESS – Functional Endoscopic Sinus Surgery Patient selection crucial! – Don’t operate for headache!Abnormal CTRestore sinus functionImprove ventilation and drainageOpen the ostiumRemove the obstructed honeycomb (ethmoids)Clear obstruction
27FESS – Surgical Aims Restore sinus function Improve ventilation and drainageOpen the ostiumRemove the obstructed honeycomb (ethmoids)Clear obstruction
28Evidence/Validation?Impact of Functional Endoscopic Sinus Surgery on Symptoms and Quality of Life in Chronic Rhinosinusitis†Michael Damm MD, Gero Quante MD, Markus Jungehuelsing MD, Eberhard Stennert MD – Laryngoscope Jan 2009Recalcitrant Rhinosinusitis, the diagnosis and treatment and evaluation of results – Rhinology 2010EPOS -