Principles of revision functional endoscopic sinus surgery

Chronic rhinosinusitis is one of the most common diagnoses in the United States and accounts for millions of dollars in health care expenditure every year. Most patients are successfully treated with medical therapy, but many require primary functional endoscopic sinus surgery (FESS) to complete their treatment. Approximately 10-15% of patients who undergo primary FESS will require revision FESS. Revision FESS has unique challenges because of the alteration of anatomical landmarks and the complexity of the underlying disease process. Successful revision FESS depends on appropriate patient and surgeon expectations, comprehensive medical therapy, complete and appropriate preoperative evaluation, and careful surgical technique and postoperative follow-up.