An Audit of Endoscopic Sinus Surgery at a Tertiary Hospital in Tanzania

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Aveline Aloyce Kahinga
Isaac John Batule
Zephania Saitabau Abraham
Elimath Martin Mushi


Endoscopic surgery, Chronic sinusitis, Indications for ESS


Background: Being a frequently used approach by otorhinolaryngologists, Endoscopic sinus surgery (ESS) has been useful in the surgical management of different sinonasal conditions in this era. Although ESS is most commonly performed for inflammatory and infectious sinus diseases, since its introduction in 1960s by Prof. Messserklinger and Wigand, the current advancement in instrumentation has led to an increase in its indications. This study therefore aimed at auditing the ESS done at a tertiary hospital in our settings.

Methodology: This was a retrospective descriptive cross-sectional study which was conducted at Muhimbili National Hospital. It involved all patients who underwent ESS in the department of otorhinolaryngology. Information was extracted from patients’ files, ledger and admission books. The obtained data were analysed using a statistical package for social sciences (SPSS) version 22. Descriptive statistics were performed to present frequency distribution of the demographic characteristics, indications for ESS and mean for the length of hospital stay.


Results: Out of 1261 surgeries done during the study period, 6.7% (84/1261) were endoscopic sinus surgeries. Of patients who underwent ESS, an almost equal proportion of males and females was found and ages ranged from 8 to 71 years with a mean age of 32 .2 ±16 .9 years.  The commonest indication for ESS was sinonasal polyposis 50.0% (42/84) followed by chronic rhinosinusitis 20.4% (17/84). The majority of patients 52.4% (44/84) had a hospital stay of 1- 3 days. The mean length of postoperative hospital stay following ESS in this study was found to be 2.8 days.

Conclusion: Endoscopic sinus surgeries accounted for 6.7% of all surgeries with sinonasal polyposis being the commonest indication and the estimated mean length of postoperative hospital stay being 3 days.

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1. Basilio F, Arantes M, Ballin A, Dallanol M, Bornhausen MB, Szkudlarek D, Santos M, et al. Efficacy of Endoscopic Sinus Surgery in the Treatment of Chronic Rhinosinusitis. Intl Arch Otorhinolaryngol, São Paulo - Brazil. 2010;14(4):433–7.

2. Tajudeen BA, Kennedy DW. Thirty years of endoscopic sinus surgery: What have we learned? World J Otorhinolaryngol Head Neck Surg. 2017;3(2):115–21.

3. Alnori HAM. Endoscopic Sinus Surgery: Indications and Complications Tikrit Medical Journal. 2013;19(1):89–94.

4. Al-Mujaini A, Wali U, Al-Khabori M. Functional endoscopic sinus surgery: Indications and complications in ophthalmic field. Oman Med J. 2009;24(2):70–80.

5. Gosepath J, Pogodsky T, Mann WJ. Characteristics of recurrent chronic rhinosinusitis after previous surgical therapy.ActaOtolaryngol. 2008 128(7):778–84

6. House W. Text book of ear nose and throat diseases. Vol. Seventh ed, Jitendar P VijJaypee Brothers Medical Publishers (P) Ltd. 2007. Pp 431.

7. Pradhan, B &Thapa N. Functional Endoscopic Sinus Surgery (FESS). Journal of Nepal Medical Association. 2006;45(164):337–41

8. Tajudeen BA, Brooks SG, Yan CH, Kuan EC, Schwartz JS, Suh JD, et al. Quality-of-life Improvement after Endoscopic Sinus Surgery in Patients with Obstructive Sleep Apnea. Allergy and Rhinology. 2017;8(1):25–31.

9. Rahman T, Alam MM, Ahmed S, Karim MA, Rahman M, Wahiduzzaman M. Outcome of Endoscopic Sinus Surgery in the Treatment of Chronic Rhinosinusitis. Mymensingh Med J. 2016;25(2):261–70.

10. Staffieri A, Marino F, Staffieri C, Giacomelli L, D’Alessandro E, Maria Ferraro S, et al. The effects of sulfurous-arsenical-ferruginous thermal water nasal irrigation in wound healing after functional endoscopic sinus surgery for chronic rhinosinusitis: a prospective randomized study. American Journal of Otolaryngology - Head and Neck Medicine and Surgery. 2008;29(4):223–9.

11. Mierzwiński J, Dalke K, Laz P, Olijewski J, Piziewicz A, Burduk PK. Functional endoscopic sinus surgery in children--our experience. OtolaryngolPol . 2006;60(4):517–20

12. Bugten V, Nordgård S, Steinsvåg S. Long-term effects of postoperative measures after sinus surgery. European Archives of Oto-Rhino-Laryngology. 2008 May;265(5):531–7.

13. Fernandes SV. Postoperative care in functional endoscopic sinus surgery?Laryngoscope .1999 ;109(6):945–8/

14. Rudmik L, Soler ZM, Orlandi RR, Stewart MG, Bhattacharyya N, Kennedy DW, et al. Early postoperative care following endoscopic sinus surgery: An evidence-based review with recommendations. Int Forum Allergy Rhinol. 2011;1(6):417–30.

15. Wu XF, Kong WF, Wang WH, Yuan LX, Xu HQ, Qi M, et al. Enhanced recovery after surgery protocols in functional endoscopic sinus surgery for patients with chronic rhinosinusitis with nasal polyps: A randomized clinical trial. Chin Med J (Engl) 2019 ;132(3):253–8.

16. Casler JD, Doolittle AM, Mair EA. Endoscopic surgery of the anterior skull base. Laryngoscope2005;115(1 I):16–24

17. Karakuş MF, Özcan KM, Özcan M, Karakurt SE, Çetin MA, Çolak M, et al. Does the Change in the Indications of Endoscopic Sinonasal Surgery Continue? Data between 1994-2018. Turk Arch Otorhinolaryngol 2020;58(1):5–9.

18. Zhang Z, Adappa ND, Doghramji LJ, Chiu AG, Lautenbach E, Cohen NA, et al. Quality of life improvement from sinus surgery in chronic rhinosinusitis patients with asthma and nasal polyps. Int Forum Allergy Rhinol. 2014;4(11):885–92.

19. Khalil HS, Nunez DA. Functional endoscopic sinus surgery for chronic rhinosinusitis. Cochrane Database Syst Rev. 2006 Jul 19;(3)

20. Rudmik L, Soler ZM, Hopkins C, Schlosser RJ, Peters A, White AA, et al. Defining appropriateness criteria for endoscopic sinus surgery during management of uncomplicated adult chronic rhinosinusitis: a RAND/UCLA appropriateness study. Int Forum Allergy Rhinol. 2016;6(6):557–67.

21. Han D, Zhou B, Liu H. Effects of endoscopic sinus surgery and relative factors. ZhonghuaEr Bi Yan HouKeZaZhi. 1996;31(1):12–5.

22. Sun H, Tan G, Xiao J. Endoscopic sinus surgery, clinical aspect with 69 cases. ZhonghuaEr Bi Yan HouKeZaZhi .1996 ;31(1):18–9.

23. Tan BK, Lane AP. Endoscopic Sinus Surgery in the Management of Nasal Obstruction. OtolaryngolClin North Am. 2009;42(2):227–40.

24. Ranga RK and Yadav SPS. Endoscopic Management of Foreign Body Nose Removal with Self Fabricated Blunt Hooks: An Experience of 1156 Cases. Otolaryngol Open Access J 2021, 6(1): 000210

25. Khan MA, Akram S, Khan M, Usman HB. Comparison of efficacy and postoperative complications between unipolar electrocautery and bipolar electrocautery in cases of anterior epistaxis: a randomized control trial. Journal of Postgraduate Medical Institute. 2017 Aug 10;31(3).

26. Al-Abbasi, A., Al-Uraibi, S., Atshan, S. Functional endoscopic sinus surgery. Basrah Journal of Surgery, 2020; 26(2): 12-18.

27. Smith LF, Brindley PC. Indications, evaluation, complications, and results of functional endoscopic sinus surgery in 200 patients.Otolaryngology-Head and Neck Surgery. 1993;108(6):688–96.