If this is not your name, click here.
| | If this is not your name, click here. | | |
| | Contact Us | Order Now | Journals | Bookstore | Register a colleague | | |
| |  Endoscopic Surgery Effectively Relieves Symptoms of Chronic Rhinosinusitis WASHINGTON, DC -- May 1, 2009 -- Endoscopic sinus surgery can significantly relieve symptoms of chronic rhinosinusitis, according to a large-scale analysis of surgical outcomes published in the May issue of the journal Otolaryngology-Head Neck Surgery. Researchers found that symptoms usually associated with the chronic condition, including nasal obstruction, facial pain, postnasal discharge, headaches, and impaired smell, all substantially improved after endoscopic sinus surgery. "This kind of surgery is indeed beneficial to patients when standard medical treatment doesn't resolve the condition," said lead investigator Alexander C. Chester, MD, Georgetown University Medical Center, Washington, DC. Endoscopic sinus surgery is an extremely common procedure, but this was the first meta-analysis of symptom relief following the surgery, said Dr. Chester. It was conducted by examining 21 different published studies, which included 2,070 patients, analysing improvement for each symptom. "Reports of relative symptom relief vary across studies, so it was important to pool the study results," he said. "We wanted to know not only if symptoms improve overall, but if they improve to a similar degree, and if these benefits last. Our findings offer reassurance that, with minor exceptions, individual symptoms usually improve substantially and similarly following surgery." He noted that the study did not attempt to prove the effectiveness of endoscopic sinus surgery compared with medical treatment. "Only a randomised, controlled clinical trial testing surgery and medical therapy could prove that point," he said. But the findings will help patients weigh both the benefits and the risks of a surgical intervention. "We now have the information we need to more accurately advise our patients," said Dr. Chester. The type of surgery studied typically used endoscopic instruments. The researchers assessed symptom relief using 2 different measures. The most precise is called 'effect size' where any effect greater than .8 is considered a large effect. The researchers found that with a 1.73effect size, nasal obstruction improved the most, followed by postnasal discharge (1.19), facial pain (1.13), headache relief (.98), and improvement in smell (.97). A second way of measuring symptoms, which is less accurate but more commonly used, compares the percent of improvement after surgery compared with before surgery. They found the following percentage improvements: 61% in facial pain, 59% in nasal obstruction, 53% in headache, 49% in smell, and 47% in postnasal discharge. They also found that improvements did not decrease over time, as some smaller studies had suggested. SOURCE: Georgetown University Medical Center
|
