Sinus surgery relieves stubborn sinusitis symptoms

By Megan Rauscher

NEW YORK (Reuters Health) - When standard medication treatment fails, sinus surgery can significantly relieve all major symptoms typically associated with chronic rhinosinusitis, including nasal obstruction, facial pain, postnasal discharge, headache and smell disturbances.

That's according to a meta-analysis of 21 relevant studies involving a total of 2070 patients with chronic rhinosinusitis who were followed for an average of 13.9 months after surgery. The results are reported in the journal Otolaryngology--Head and Neck Surgery.

This is the first meta-analysis that has focused on symptom relief following endoscopic surgery and "gives the largest body of evidence that improvement is noted generally," Dr. Alexander C. Chester, of Georgetown University Medical Center in Washington, D.C., commented to Reuters Health.

"It has never been clear about which symptoms improve the most and there was some concern about smell disturbances not improving, so it was important to pool the study results," Chester added.

The meta-analysis showed that all symptoms improved significantly following endoscopic sinus surgery; the overall average effect size was 1.19. "This is a strong effect size," Chester pointed out, given that any effect size greater than 0.8 is considered large.

The effect size was most prominent for nasal obstruction (1.73), followed by facial pain (1.13), postnasal discharge (1.19), headache (0.98) and excessive sleeping (0.97).

In before and after analyses, nasal obstruction, facial pain, headache, smell and postnasal discharge improved by roughly 59 percent, 61 percent, 53 percent, 49 percent and 47 percent, respectively, following surgery.

"The results are very reassuring to patients," he told Reuters Health, and a large experience with endoscopic sinus surgery indicates that success is usually what follows."