Best Practice in the Management of Concha Bullosa in FESS Operation

Inclusion Criteria

• •chronic or recurrent rhinosinusitis
• •3 months of regular nasal corticosteroid usage
• •No prior endoscopic procedures of the paranasal sinuses
• •EPOS criteria for CRS are met: inflammation of the paranasal sinuses with at least 2 symptoms, one of which must be nasal obstruction/congestion or nasal discharge (anterior/posterior):
• •* facial pain/pressure in the facial area
• •* reduced or lost sense of smell SNOT-22 25 or higher
• •* Complications of CRS (e.g., mucocele)
• •* Pregnancy/breastfeeding or plans for them in the near future
• •* Coagulation disorders
• •* Systemic diseases: cystic fibrosis, primary ciliary dysfunction, sarcoidosis, Wegener's granulomatosis
• •* Immunosuppression: diagnosed SAD, CVI, HIV, or use of biological/immunosuppressive drugs
• •* Immunotherapy
• •* Daily use of systemic corticosteroids
• •* Communication issues (non-Finnish-speaking patient, neurological/psychiatric problems)
• •* SNOT-22 score \< 25