Surgical techniques
All patients underwent ESS under general anesthesia and video recorded
by either a blinded
rhinologist staff or a fellowship-trained rhinologist supervised by
rhinologist staff. The sinuses were sequentially opened into the common
cavity fashion: uncinectomy and middle meatal antrostomy, anterior and
posterior ethmoidectomy, sphenoidotomy and frontal sinusotomy (Draf
IIa). The blue-light filter system with 0, 45, and 70-degree nasal
endoscopes (Karl Storz, Tuttlingen, Germany) were applied during video
record at each interesting anatomical area, including the OMU, maxillary
sinus, anterior and posterior ethmoid air cells, sphenoid sinus and
frontal sinus, respectively aiming to examine the degree of fluorescein
stain. The normal saline irrigation and the application of cotton
pledget were not allowed to be used during the procedure. Patients with
significant intraoperative bleeding must be excluded from the data
analysis due to fluorescein obscuring.