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

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.背景：鼻内镜鼻窦手术（Endoscopic sinus surgery, ESS）是耳鼻喉科医师常用的术式，在当前时代广泛应用于多种鼻窦鼻腔疾病的外科治疗。尽管ESS最初最常用于炎性及感染性鼻窦疾病的治疗，自1960年代由Messserklinger教授与Wigand教授首次开展以来，随着手术器械的不断进步，其临床适应证已得到拓展。本研究旨在对本医疗环境下某三级医院开展的ESS手术进行审计分析。 方法：本研究为在穆希比利国家医院开展的回顾性描述性横断面研究，纳入所有在该院耳鼻喉科接受ESS手术的患者。研究数据从患者病历、手术登记本与入院登记册中提取，采用社会科学统计软件包（SPSS）22.0版本进行数据分析。通过描述性统计分析，呈现患者人口统计学特征、ESS手术适应证的频数分布，以及住院时长的均值情况。 结果：本研究周期内共计完成1261台手术，其中6.7%（84/1261）为ESS手术。接受ESS的患者中，男性与女性占比近乎均等，年龄分布为8~71岁，平均年龄为32.2±16.9岁。ESS最常见的适应证为鼻窦鼻息肉病，占比50.0%（42/84），其次为慢性鼻-鼻窦炎，占比20.4%（17/84）。多数患者（52.4%，44/84）的住院时长为1~3天，本研究中ESS术后平均住院时长为2.8天。 结论：ESS手术占所有手术的6.7%，其中鼻窦鼻息肉病为最常见的手术适应证，术后平均住院时长约为3天。