Background. Endoscopic sinus surgery (ESS) is considered for chronic rhinosinusitis (CRS) after failure of conservative therapy. Objective. The aim of this study was to evaluate endoscopically ostium patency and mucosal recovery after ESS, with either maxillary sinus ostium-preserving or -enlarging techniques. Materials and Methods. Thirty patients with non-polypous CRS were enrolled. Uncinectomy-only and additional middle meatal antrostomy were randomly and single-blindly performed for each side. Pre- and postoperative endoscopic scores were semi-quantitatively determined according to findings in the ostiomeatal complex area. Adhesions, maxillary sinus mucosal swelling, secretions, and ostium obstruction were also endoscopically evaluated. In addition, symptoms were asked and computed tomography scans were taken preoperatively and 9 months postoperatively. Results. At 16 days postoperatively, a better endoscopic score and a less obstructed ostium were found with antrosomy. At 9 months postoperatively the endoscopic score improved significantly and identically with both procedures, however, obstructed ostia and sinus mucosal swelling/secretions were insignificantly more frequently found on the uncinectomy-only side. Endoscopic and radiologic findings of the maxillary sinus mucosa and ostium correlated significantly 9 months postoperatively. Conclusion. There was a good long-term mucosal recovery with both surgical procedures. In terms of early mucosal recovery and ostium patency, antrostomy might be slighly superior. 1. Introduction Chronic rhinosinusitis (CRS) is an inflammation of the nose and paranasal sinuses lasting more than 12 weeks with a prevalence of about 10% in Europe [1, 2]. It is diagnosed by typical symptoms and/or computed tomography (CT) scan and/or endoscopic changes [1]. After failure of conservative therapy, endoscopic sinus surgery (ESS) aims to restore mucociliary clearance and ventilation through the natural ostia. ESS is based on the theory that the maxillary sinus ostium is the most important area in the pathogenesis of chronic and recurrent rhinosinusitis [3, 4]. Obstruction of the ostium is believed to lead to chronic inflammation and eventually to pathologic alterations of the maxillary sinus mucosa. Therefore, surgical opening of the ostium and thus improved drainage and ventilation of the sinus might restore the normal mucosa [5]. There are different opinions concerning the extent of surgery of the ostiomeatal complex. It is considered that removal of the uncinate process alone would be enough to restore the ventilation of
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