Minimally Invasive Sinus Surgery in the Geriatric Patient

The outcome of minimally invasive sinus surgery in patients over age 65 has not yet been reported. Geriatric patients who have objective clinical findings and extensive medical histories that would usually warrant surgical intervention are often managed medically for various reasons, chief among which may be the rationale that many older patients have lived with their symptoms for many years and can continue to do so. Surgeons may fear an increased complication rate or poor outcome caused by a general conception of frailty in the elderly. Perhaps there is also a lack of appreciation for the profound effect that chronic sinus disease can have on quality of life in older adults. We retrospectively reviewed our experience with minimally invasive sinus techniques (MIST) in 100 consecutive patients between the ages of 65 and 91 years (average age, 74.5 years). All patients were operated on between June 1996 and August 1998 with minimally invasive techniques and had a minimum follow-up time of 3 months. Epistaxis requiring treatment was the major surgical complication, occurring in 2 patients. None of the patients experienced an exacerbation of an underlying medical condition, and all medical complications were minor and transient. Quality of life was significantly improved in 84%, and somewhat improved in an additional 10%. In none of the patients was quality of life worsened. Patient selection criteria for the use of MIST in the treatment of chronic sinus disease in the geriatric population is no different than for those under age 65.