Long-term outcomes of endoscopic maxillary mega-antrostomy for refractory chronic maxillary sinusitis

Int Forum Allergy Rhinol. 2015 Jan;5(1):60-5. doi: 10.1002/alr.21407. Epub 2014 Oct 13.

Abstract

Background: Endoscopic maxillary mega-antrostomy (EMMA) is a revision surgical procedure for recalcitrant maxillary sinusitis in which medical therapy and endoscopic antrostomy have been unsuccessful. In 2008 our group published favorable outcomes of EMMA in 28 patients with relatively short follow-up and nonvalidated outcome measures. This study reports an update of long-term outcomes of this same cohort, as well as outcomes of an interval cohort of 94 patients using validated outcome measures.

Methods: Retrospective review was performed for 122 patients (163 sides) who underwent EMMA between 2005 and 2013. For the original 2008 cohort, the original questionnaire from 2008 was readministered by telephone interview. For the interval cohort, preoperative and postoperative SNOT-22 symptom scores and modified Lund-Kennedy endoscopic scores were compared.

Results: The original 2008 cohort of 28 patients, now with a mean follow-up period of 6.9 years, demonstrated sustained improvement of symptoms. The outcomes were statistically comparable to the 2008 study, with 72.4% reporting complete or significant improvement, 27.6% reporting partial improvement, and 0% reporting worsening.

Keywords: chronic rhinosinusitis; cystic fibrosis; endoscopic medial maxillectomy; endoscopic sinus surgery; maxillary sinusitis; mega-antrostomy; refractory sinusitis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chronic Disease
  • Cohort Studies
  • Drug Resistance
  • Endoscopy*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Maxillary Sinus / diagnostic imaging*
  • Maxillary Sinus / surgery
  • Maxillary Sinusitis / diagnosis*
  • Maxillary Sinusitis / surgery
  • Middle Aged
  • Recurrence
  • Retrospective Studies
  • Surveys and Questionnaires
  • Time Factors*
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Young Adult