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Endoscopic endonasal surgery for sinonasal polyposis: a comparative study between general versus local anesthesia regarding compliance of surgery and patients’ acceptance



One of the most common inflammatory mass lesions of the nose are nasal polyps, which affect up to 4% of the population. Endoscopic surgery under local anesthesia may allow for a day-care surgical procedure for the patient; however, extensive procedures, revision surgeries, and uncooperative, and pediatric age group patients will warrant the use of general anesthesia. The aim of this study is to compare the efficacy of local versus general anesthesia for endoscopic surgical treatment of sinonasal polyposis during operation as well as during early and late postoperative periods together with patient’s acceptance for surgery.

Patients and methods

A total of 60 patients with sinonasal polyposis were divided randomly into two groups. Group 1 underwent endoscopic nasal surgery under local anesthesia and group 2 underwent endoscopic nasal surgery under general anesthesia.


Most of the patients who were operated under local anesthesia showed good acceptance for surgery, short time of surgery, and less bloody field than those who were operated under general anesthesia (the P value was significant regarding bleeding and time during surgery under local anesthesia).


Surgery of sinonasal polyposis under local anesthesia is an effective method for the treatment of nasal polyposis as regards patient acceptance for the surgery, time of surgery with very good surgical field, and less cost procedures.


  1. Rajguru R. Nasal polyposis. Current trends. Indian J Otolaryngol Head Neck Surg 2011; 66:16–21.

    Article  PubMed  Google Scholar 

  2. Fedok FG, Ferraro RE, Kingsley CP, Fornadley JA. Operative times, post anesthesia recovery times, and complications during sinonasal surgery using general anesthesia and local anesthesia with sedation. Otolaryngol Head Neck Surg 2000; 122:560–566.

    PubMed  CAS  Google Scholar 

  3. Singh PM, Pahwa D. Anaesthesia for endoscopic endonasal surgery. Tr Anaesth Crit Car 2011; 1:79–83.

    Article  Google Scholar 

  4. Hopkins C, Browne JP, Slack R. The Lund-Mackay staging for chronic rhinosinusitis: how is it used and what does it predict?. Otolryngol Head Neck Surg 2007; 137:555–561.

    Article  Google Scholar 

  5. Lund VJ, Mackay IS. Staging in rhinosinusitis. Rhinology 1993; 31:183–184.

    PubMed  CAS  Google Scholar 

  6. Stammberger H, Posawetz W. Functional endoscopic sinus surgery. concept, indications and results of the Messerklinger technique. Eur Arch Otorhinolaryngol 1990; 247:63–76.

    PubMed  CAS  Google Scholar 

  7. Jensen MP, McFarland CA. Increasing the reliability and validity of pain intensity measurement in chronic pain patients. Pain Manag Nurs 1993; 55:195–203.

    CAS  Google Scholar 

  8. Rodriguez CS. Pain measurement in the elderly: a review. Pain Manag Nurs 2001; 2:38–46.

    Article  CAS  PubMed  Google Scholar 

  9. Fromme GA, MacKenzie RA, Gould AB, Lund BA, Offord KP. Controlled hypotension for orthognatic surgery. Anesth Analg 1986; 65:683–686.

    Article  CAS  PubMed  Google Scholar 

  10. Casale M, Cusimano V, Salvinelli F, Setola R, Soda P. Video-rhinohygrometer (VRH). Conf Proc IEEE Eng Med Biol Soc 2006; 1:543–546.

    Article  Google Scholar 

  11. Danielsen A, Gravningsbraten R, Olofsson J. Anaesthesia in endoscopic sinus surgery. Eur Arch Otorhinolaryngol 2003; 260:481–486.

    Article  PubMed  Google Scholar 

  12. Danielsen A, Olofsson J. Endoscopic endonasal sinus surgery. A long-term follow-up study. Acta Otolaryngol (Stockh) 1996; 116:611–619.

    Article  CAS  Google Scholar 

  13. Gurr P, Callanan V, Baldwin D. Laser-Doppler blood flowmetry measurement of nasal mucosa blood flow after injection of the greater palatine canal. J Laryngol Otol 1996; 110:124–128.

    Article  CAS  PubMed  Google Scholar 

  14. Abu-Zaid E, Ahmed M. Role of intraoperative endoscopic sphenopalatine ganglion block in sinonasal surgery. J Med Sci 2007; 7:1297–1303.

    Article  Google Scholar 

  15. Kennedy DW. Functional endoscopic sinus surgery: technique. Arch Otolaryngol 1985; 111:643–649.

    Article  CAS  PubMed  Google Scholar 

  16. Carlson D. The real cost of sinus surgery. 2015. Available at: [Accessed on 2018 Sep 9]

  17. Gittelman PD, Jacobs JB, Skorina J. Comparison of functional endoscopic sinus surgery under local and general anesthesia. Ann Otol Rhinol Laryngol 1993; 102:289–293.

    Article  CAS  PubMed  Google Scholar 

  18. Tosun F, Arslan HH, Karslioglu Y. Relationship between postoperative recurrence rate and eosinophil density of nasal polyps. Ann Otol Rhinol Laryngol 2010; 119:455–459.

    Article  PubMed  Google Scholar 

  19. Pujols L, Alobid I, Benitez P. Regulation of glucocorticoid receptor in nasal polyps by systemic and intranasal glucocorticoids. Allergy 2008; 63:1377–1386.

    Article  CAS  PubMed  Google Scholar 

  20. Esmatinia F, Bakhshaei M. Recurrent sinonasal polyposis after the endoscopic sinus surgery. Rev Clin Med 2014; 1:86–92.

    Google Scholar 

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Correspondence to Ahmed M. El Batawi MD.

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Zeid, N.G., Zaid, E.A., Kamel, A. et al. Endoscopic endonasal surgery for sinonasal polyposis: a comparative study between general versus local anesthesia regarding compliance of surgery and patients’ acceptance. Egypt J Otolaryngol 35, 241–245 (2019).

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  • endoscopic sinus surgery
  • general anesthesia
  • local anaethesia
  • patient’s acceptance