Objective assessment of endoscopic sinus surgery in the management of chronic rhinosinusitis: an update.

Whilst clinical success of endoscopic surgery for chronic rhinosinusitis has necessarily depended primarily upon subjective evaluation, a range of objective techniques are now available which may facilitate our interpretation of results. A group of 200 patients underwent assessment of symptoms by sequential visual analogue scoring, olfaction by qualitative and quantitative testing, nasal airflow by forced inspiratory peak flow, anterior rhinomanometry, nasomucociliary function by ciliary beat frequency and nasal topography by acoustic rhinometry performed pre- and post-operatively. Significant improvement was demonstrated in all symptoms examined, olfactory tests and ciliary beat frequency whilst acoustic rhinometry provided an attempt to quantify the surgical cavities. These results offer an interesting perspective on the pathology of rhinosinusitis and the rationale for surgery within the ostiomeatal complex.