Our Summary

This study is about a medical procedure called endoscopic sinus surgery (ESS), which is used as a treatment option for people who have chronic sinus inflammation (CRS) and have not responded to standard medication treatments. However, the researchers found that there is no agreement on what exactly constitutes standard treatment.

They conducted a review of studies published within a five-year period (2009-2014) to see what kinds of treatments were tried before deciding to do surgery. They looked at studies involving adults with CRS who were going to have ESS. Any studies involving people who were having ESS for reasons other than CRS were not included.

The researchers found that only about one-fifth of the studies they reviewed actually reported the standard treatments used before surgery was considered. When it was reported, the most common treatments included nasal steroid sprays used for about 8 weeks, oral antibiotics used for about 23 days, and systemic corticosteroids used for about 18 days.

Less commonly used treatments included saline irrigations, oral antihistamines, mucus thinners, and decongestants. The use of systemic corticosteroids did not change based on whether the patient had nasal polyps.

The researchers concluded that, because there is such variation in the standard treatments used before considering ESS, there needs to be a standard set of guidelines for when to consider ESS. This could help ensure that patients receive the most appropriate care.

FAQs

  1. What is endoscopic sinus surgery (ESS) primarily used for?
  2. What were the most common treatments used before considering ESS according to the studies reviewed?
  3. Why did the researchers suggest the need for a standard set of guidelines for considering ESS?

Doctor’s Tip

One helpful tip a doctor might tell a patient about sinus surgery is to make sure to follow all pre-operative instructions provided by the healthcare team. This may include stopping certain medications, fasting before surgery, and avoiding certain activities. Following these instructions can help ensure a successful surgery and smooth recovery. Additionally, it is important to communicate any concerns or questions with your healthcare provider before the procedure.

Suitable For

In general, patients who are recommended sinus surgery are those who have chronic sinus inflammation (CRS) that has not responded to standard medication treatments. This can include patients who have tried nasal steroid sprays, oral antibiotics, systemic corticosteroids, saline irrigations, oral antihistamines, mucus thinners, and decongestants without success. Patients may also have nasal polyps, which can further complicate sinus inflammation and may require surgical intervention. Ultimately, the decision to recommend sinus surgery is made on a case-by-case basis by a healthcare provider, taking into consideration the patient’s individual symptoms, medical history, and response to previous treatments.

Timeline

Before sinus surgery:

  • Patient experiences chronic sinus inflammation (CRS) that has not responded to standard medication treatments
  • Patient may undergo treatments such as nasal steroid sprays, oral antibiotics, systemic corticosteroids, saline irrigations, oral antihistamines, mucus thinners, and decongestants
  • The use of systemic corticosteroids may vary depending on the presence of nasal polyps

After sinus surgery:

  • Patient undergoes endoscopic sinus surgery (ESS) as a treatment option for CRS
  • Recovery period typically lasts a few weeks, during which the patient may experience pain, swelling, and congestion
  • Follow-up appointments are scheduled to monitor healing and ensure proper recovery
  • Patient may experience improved sinus symptoms and quality of life after surgery, with long-term benefits seen in the reduction of CRS symptoms

What to Ask Your Doctor

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

  1. What specific symptoms or conditions indicate that I may need sinus surgery?
  2. What other treatment options have been tried or considered before recommending surgery?
  3. What are the potential risks and benefits of sinus surgery in my case?
  4. What is the success rate of sinus surgery for patients with my condition?
  5. What is the recovery process like after sinus surgery?
  6. How long will it take for me to see improvement in my symptoms after surgery?
  7. Are there any lifestyle changes or medications I should be aware of post-surgery?
  8. How often will I need follow-up appointments after sinus surgery?
  9. Are there any long-term effects or complications I should be aware of after sinus surgery?
  10. Are there any alternative treatments or second opinions I should consider before proceeding with surgery?

Reference

Authors: Dautremont JF, Rudmik L. Journal: Int Forum Allergy Rhinol. 2015 Dec;5(12):1095-103. doi: 10.1002/alr.21601. Epub 2015 Jul 22. PMID: 26201538