Factors affecting the outcome of endoscopic sinus surgery: Our experience in a resource-constraint setting

Abstract

Background: Endoscopic sinus surgery (ESS) has recorded an excellent success rate, ranging from 80%–98% in the developed countries. However, the outcome in a resource-constraint setting may not be the same due to several factors associated with the patient, the clinical course, and the management of the disease. Objective: The aim of this study was to examine the factors that affect the outcome of ESS in a resource-constraint setting. Materials and Methods: Clinical, radiological, surgical, and outcome data of patients who had ESS at a newly established tertiary hospital from January 2018 to June 2022 were reviewed. Patients with complete resolution of symptoms and absence of disease on postoperative endoscopy were considered to have “satisfactory outcome.” Those with either recurrence or residual disease were considered to have “unsatisfactory outcome.” Chi-square and logistic regression analyses were carried out to determine the factors and predictors of outcome. Results: Fifty-three patients were evaluated, comprised of 29 (54.7%) males and 24 (45.3%) females. The age of the patients ranged between 11 and 67 years with a median of 33 years. The majority of the patients (67.9%) had satisfactory outcome, but 32.1% had unsatisfactory outcome. The complication rate was 26.4%, although the majority (24.5%) had minor complications. Factors associated with outcome were nasal allergy (P = 0.000), nasal polyps (P = 0.000), and anatomical variation (P = 0.045). However, only nasal allergy (P = 0.046) and nasal polyps (P = 0.004) were significant predictors of unsatisfactory outcome on logistic regression analysis. Conclusion: The outcome of ESS is also good in resource-constraint setting. However, a significant unsatisfactory outcome was recorded, factors such as the presence of allergy and nasal polyps may predict the unsatisfactory outcome. Therefore, allergy and nasal polyps should be evaluated thoroughly while preparing patient for ESS.