D Kleemann1, S Nofz, I Plank, A Schlottmann. 1. MediClin AG, HNO-Klinik der Müritz-Klinikum GmbH Waren, Waren. detlef.kleemann@mueritz-klinikum.de
Abstract
BACKGROUND: The healing process after functional endoscopic sinus surgery (FESS) normally takes weeks to months under an intensive therapy regime. Occasionally, symptomatic failures and local problems occur despite extensive follow-up treatment. PATIENTS AND METHODS: Over a 3-year period 900 patients underwent FESS in our department. Of these patients, 79 were found with no tendency toward improvement of symptoms and signs more than 3 weeks after the operation. Nasal obstruction, frontal headache, and postnasal drainage were evaluated to be the frequent postoperative complaints. Scarring of the middle meatal antrotomy and the ethmoid, inflammatory granulation, and early recurrence of polyps occurred as the local problems. Historical factors and clinical signs of gastroesophageal or laryngopharyngeal reflux were examined in this group. Afterwards, proton pump inhibitors were prescribed on a trial basis. RESULTS: Historical clues of reflux were reported by 30 patients only. However, clinical signs of a reflux were found in 66 cases. Rhinological symptoms and signs were improved in 60 patients following the application of proton pump inhibitors over 2 weeks. CONCLUSION: Our results support earlier experiences reported in the literature. Laryngopharyngeal reflux could be a factor altering the healing process after FESS.
BACKGROUND: The healing process after functional endoscopic sinus surgery (FESS) normally takes weeks to months under an intensive therapy regime. Occasionally, symptomatic failures and local problems occur despite extensive follow-up treatment. PATIENTS AND METHODS: Over a 3-year period 900 patients underwent FESS in our department. Of these patients, 79 were found with no tendency toward improvement of symptoms and signs more than 3 weeks after the operation. Nasal obstruction, frontal headache, and postnasal drainage were evaluated to be the frequent postoperative complaints. Scarring of the middle meatal antrotomy and the ethmoid, inflammatory granulation, and early recurrence of polyps occurred as the local problems. Historical factors and clinical signs of gastroesophageal or laryngopharyngeal reflux were examined in this group. Afterwards, proton pump inhibitors were prescribed on a trial basis. RESULTS: Historical clues of reflux were reported by 30 patients only. However, clinical signs of a reflux were found in 66 cases. Rhinological symptoms and signs were improved in 60 patients following the application of proton pump inhibitors over 2 weeks. CONCLUSION: Our results support earlier experiences reported in the literature. Laryngopharyngeal reflux could be a factor altering the healing process after FESS.