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.