This review discusses the outcome measures that may be considered in the assessment of patients with chronic rhinosinusitis (CRS) as well as the outcomes of endoscopic sinus surgery (ESS) published so far. The authors also discuss the role of peri-operative decision and their influence on surgical outcomes with special focus on patient selection, extent of surgery and choice of postoperative care. The study reports that the outcome measures in CRS have evolved over the past two decades. The trend has shifted away from objective measurements as primary outcome, towards patient-reported outcomes.
The authors found insufficient Level 1 evidence of benefit from ESS over continued medical therapy in patients who had failed initial medical therapy. They did find evidence to suggest that ESS may positively influence asthma control and that earlier surgical intervention in patients with CRS who fail initial medical therapy results in improving symptomatic outcomes.
They recommend future randomized controlled trials and studies to evaluate the benefits of surgery over continued medical therapy in patients who fail initial medical therapy. – GM