Computed Tomographic Staging and the Fate of the Dependent Sinuses in Revision Endoscopic Sinus Surgery

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Abstract
ENDOSCOPIC SINUS surgery (ESS) has emerged as the procedure of choice in the management of chronic sinusitis for which medical management has failed. Several recent reports have verified the short- and long-term value of ESS in managing refractory chronic sinusitis.1-3 However, failure to control subjective symptoms, as well as the objective follow-up findings of chronic sinusitis, remain challenging problems with the surgical management of chronic sinusitis. The surgical failure rate, when defined by persistent symptoms of chronic sinusitis, ranges from 3% to 20%.4 The failure rate increases when more objective measures, such as abnormal findings on postoperative endoscopy or on postoperative computed tomography (CT) scans, are used.5 Despite these problems, Senior et al1 have shown that the overall success rate for ESS is maintained even with long-term follow-up, although up to 18% of cases may require revision surgery.