Our Summary

This research paper examines the practice of taking multiple samples from different sinuses during a type of nose surgery called endoscopic sinus surgery (ESS). The aim was to see if taking multiple samples helps to identify more disease-causing organisms, or if it’s an unnecessary and costly practice.

The researchers looked at data from a single nose specialist’s surgeries from 2008 to 2016. They included patients who had ESS for a long-lasting sinus condition (chronic rhinosinusitis or CRS) and had multiple samples taken during surgery. The researchers were particularly interested in cases where different disease-causing organisms were found in samples from different sinuses.

They found that in around 40% of patients, different organisms were found in samples from different sinuses. However, only 5% of patients had a change in their antibiotic treatment as a result of the second sample.

The researchers concluded that for nose specialists who take samples during surgery, it is more cost-effective to take just one sample rather than multiple ones. This could help to reduce healthcare costs for patients with CRS.

FAQs

  1. What is the purpose of taking multiple samples during endoscopic sinus surgery?
  2. What percentage of patients had different organisms found in samples from different sinuses?
  3. Did the researchers find it more cost-effective to take multiple samples or just one sample during sinus surgery?

Doctor’s Tip

A doctor might tell a patient undergoing sinus surgery that taking multiple samples from different sinuses during surgery may not always be necessary and could potentially increase costs without significantly impacting treatment decisions. It’s important to trust your doctor’s judgment and follow their recommendations for the best outcome.

Suitable For

Typically, patients who are recommended sinus surgery are those who have chronic sinusitis that does not respond to other treatments such as medications, nasal sprays, or allergy treatments. Sinus surgery may also be recommended for patients with nasal polyps, a deviated septum, or other structural issues that are causing sinus blockages and recurrent infections. Additionally, patients with severe sinusitis symptoms such as facial pain, pressure, headaches, and difficulty breathing may also be recommended for sinus surgery. Ultimately, the decision to undergo sinus surgery is made on a case-by-case basis by a healthcare provider after a thorough evaluation of the patient’s symptoms and medical history.

Timeline

Before sinus surgery:

  1. Patient experiences symptoms of chronic rhinosinusitis (CRS) such as facial pain, congestion, nasal discharge, and loss of smell.
  2. Patient undergoes diagnostic tests such as CT scans and nasal endoscopy to confirm the diagnosis.
  3. Patient may try various treatments such as antibiotics, nasal steroids, and saline rinses to manage symptoms.
  4. If symptoms persist, patient may be recommended for endoscopic sinus surgery (ESS) to improve sinus drainage and alleviate symptoms.

After sinus surgery:

  1. Patient undergoes ESS, where a nose specialist uses a thin, flexible tube with a camera to remove blockages and diseased tissue from the sinuses.
  2. During surgery, multiple samples are taken from different sinuses to identify disease-causing organisms.
  3. Patient may experience mild pain, swelling, and nasal congestion in the days following surgery.
  4. Patient follows post-operative instructions such as saline rinses, nasal steroid sprays, and avoiding strenuous activities.
  5. Follow-up appointments are scheduled to monitor healing and address any concerns.
  6. Patient may experience improved sinus drainage and reduction in CRS symptoms after surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about sinus surgery include:

  1. Why is sinus surgery recommended for my condition?
  2. What are the potential risks and complications associated with sinus surgery?
  3. What is the success rate of sinus surgery for treating chronic rhinosinusitis?
  4. Will I need to have multiple samples taken during surgery? Why or why not?
  5. How will the results of the samples taken during surgery affect my treatment plan?
  6. How will sinus surgery improve my symptoms and quality of life?
  7. What is the recovery process like after sinus surgery?
  8. Are there any alternative treatments to sinus surgery that I should consider?
  9. How often do patients need to undergo revision sinus surgery?
  10. What should I expect in terms of follow-up appointments and long-term care after sinus surgery?

Reference

Authors: Miller C, Davis GE. Journal: Int Forum Allergy Rhinol. 2018 Apr;8(4):504-508. doi: 10.1002/alr.22068. Epub 2018 Jan 5. PMID: 29316282