Our Summary

This research paper looks at two treatments for chronic sinusitis with nasal polyps - a condition where noncancerous growths develop in the nasal passages leading to problems like a runny nose, congestion, and reduced sense of smell. The two treatments compared are a type of surgery called functional endoscopic sinus surgery (FESS) and a drug treatment called dupilumab.

The researchers assessed the effectiveness of these treatments by looking at several measures such as nasal congestion, quality of life related to sinus symptoms, ability to smell, and size of the nasal polyps. They analyzed four previous studies that involved a total of 724 participants.

The findings show that in the months following treatment, the surgery was more effective than the drug in reducing nasal congestion and polyp size. However, after about a year, the effectiveness of both treatments was shown to be similar. Interestingly, patients who took dupilumab had a better sense of smell after one year compared to those who had surgery.

In simple terms, if you have chronic sinusitis with nasal polyps, both surgery and drug treatment can be helpful. Surgery might give quicker results, but over the long term, both methods are equally effective. And if improving your sense of smell is a priority, the drug treatment might be a better option.

FAQs

  1. What is the recommended treatment when conventional medical management doesn’t resolve chronic rhinosinusitis with nasal polyposis?
  2. How do the effects of dupilumab and functional endoscopic sinus surgery (FESS) compare in treating chronic rhinosinusitis with nasal polyps?
  3. Which treatment showed greater olfactory improvement a year after the procedure, dupilumab or functional endoscopic sinus surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about sinus surgery is to follow post-operative care instructions carefully to ensure a successful recovery. This may include taking prescribed medications, avoiding strenuous activities, keeping the nasal passages clean, and attending follow-up appointments with your healthcare provider. It is also important to communicate any concerns or unusual symptoms to your doctor promptly.

Suitable For

Patients with chronic rhinosinusitis with nasal polyposis who have not responded well to conventional medical management are typically recommended for sinus surgery. These patients may experience symptoms such as nasal congestion, difficulty breathing, reduced sense of smell, and nasal polyps. Sinus surgery, specifically functional endoscopic sinus surgery (FESS), is often considered when other treatments have not provided adequate relief. In some cases, patients may also be recommended for sinus surgery if they have recurrent sinus infections or other complications related to their chronic rhinosinusitis.

Timeline

  • Prior to sinus surgery, a patient may have been experiencing chronic rhinosinusitis with nasal polyps and may have tried conventional medical management without success.
  • The patient may have consulted with an otolaryngologist who recommended functional endoscopic sinus surgery (FESS) as a treatment option.
  • The patient would undergo preoperative evaluations and tests to assess their suitability for surgery.
  • The FESS procedure would be performed, typically under general anesthesia, to remove nasal polyps, open up blocked sinuses, and improve sinus drainage.
  • After surgery, the patient would have a period of recovery, which may include postoperative care instructions, medications, and follow-up appointments with their surgeon.
  • In the weeks and months following surgery, the patient may experience improvements in symptoms such as nasal congestion, sense of smell, and overall quality of life.
  • The patient may also undergo follow-up tests and assessments to monitor the effectiveness of the surgery and the long-term outcomes.
  • In some cases, patients may also be prescribed dupilumab, a biological product, as an alternative treatment for chronic rhinosinusitis with nasal polyps.
  • Studies have shown that while FESS may be more effective than dupilumab in the short term, the effects of the two treatments become similar after around 1 year, with greater olfactory improvement seen in the dupilumab group.

What to Ask Your Doctor

  1. What are the potential risks and complications of sinus surgery?
  2. How long is the recovery period after sinus surgery?
  3. Will I need to take time off work or make any lifestyle changes after the surgery?
  4. How likely is it that the sinus problems will return after surgery?
  5. Are there any alternative treatments to consider before opting for surgery?
  6. Will I need any additional treatments or medications after the surgery?
  7. How long can I expect the benefits of sinus surgery to last?
  8. What can I do to optimize my chances of a successful outcome from sinus surgery?
  9. Will I need any follow-up appointments or tests after the surgery?
  10. How experienced are you in performing sinus surgery, and what is your success rate with this procedure?

Reference

Authors: Kim DH, Stybayeva G, Hwang SH. Journal: Am J Rhinol Allergy. 2024 Nov;38(6):428-436. doi: 10.1177/19458924241272978. Epub 2024 Aug 16. PMID: 39149992