Subjects
Patients diagnosed with unilateral CRS who underwent FESS at Kaohsiung
Chang Gung Memorial Hospital between April 2016 and November 2017 were
prospectively included. The diagnosis criteria followed the 2015
clinical practice guidelines from the American Academy of
Otolaryngology-Head and Neck Surgery Foundation.12 All
patients received adequate medical treatment, including intranasal
corticosteroids for at least 2 months and oral steroids or antibiotics
(depending on their condition) for 2 to 4 weeks. Patients with a history
of palatal disease/surgery, motor speech disorders, immunodeficiency,
previous radiotherapy of the head and neck region, previous sinonasal
surgery, and tonsillectomy were excluded. Patients with adjunctive
inferior turbinate surgery were also excluded. All patients signed
informed consent forms before the operation. Paranasal sinus computed
tomography (CT) was performed prior to the operation. The extent of
surgery was decided according to the severity of the disease. Limited
surgery was defined as maxillary antrostomy with partial anterior
ethmoidectomy or sphenoidectomy only. The wide opening surgery was
defined as at least 3 sinuses were opened. All patients were regularly
followed up at 3-month intervals. After the operation, all patients
underwent nasal saline irrigation and received intranasal
corticosteroids for at least 1 month according to their condition.
Patients with nasal polyps received oral steroids for at least 2 weeks
and oral antibiotics for 2 to 4 weeks in cases of acute exacerbation.
All patients underwent sinonasal endoscopy and completed the 22-Item
Sino-nasal Outcome Test (SNOT-22) before and during the follow-up
period.