Revision endoscopic sinus surgery

Patients with recurrent chronic sinusitis after prior surgical intervention pose a particular challenge to the otorhinolaryngologist. Establishing a correct diagnosis is the first step. Although primary chronic rhinosinusitis is typically a medical disease, postsurgical persistent disease may result directly from iatrogenic causes, requiring early surgical revision. Even in this setting, however, proper preoperative medical therapy is essential. When the decision to undergo revision surgery is made, the patient and the physician need to comprehend the rigorous and prolonged schedule of postoperative care and debridements that may be required for long-term success. Medical management and endoscopic surveillance postoperatively is continued until a stable cavity is achieved.