Both full and limited endoscopic sinus surgery significantly improve quality of life in patients with chronic rhinosinusitis

Both full and limited endoscopic sinus surgery significantly improve quality of life in patients with chronic rhinosinusitis with nasal polyps, according to a recent study published in Allergy. In both groups, patients’ symptoms decreased to such an extent that the change remained clinically significant even two years after surgery.

The randomised controlled trial conducted by Helsinki University Hospital, Kuopio University Hospital and the University of Eastern Finland involved 97 patients. One year after surgery, the mean SNOT-22 score – a health-related quality of life questionnaire which describes patients’ symptoms – was 22.3 in the group that underwent full endoscopic sinus surgery and 31.5 in the group that underwent limited endoscopic sinus surgery. At the two-year follow-up, the corresponding mean SNOT-22 scores were 25.3 and 27.8. However, the difference between the groups in the change in the total SNOT 22 score was not statistically significant and did not exceed the threshold for minimal clinically important difference.

Full surgery, however, yielded better results in terms of outcomes such as the recovery of the sense of smell and reduced nasal polyp size. The findings suggest that full surgery may control inflammation more effectively than limited surgery, although patients’ perceived overall quality of life improved equally well in both groups.

Professor Sanna Toppila-Salmi of the University of Eastern Finland emphasises that the study provides high-quality evidence for the effectiveness of surgical treatment for chronic rhinosinusitis with nasal polyps. The findings help physicians assess when more extensive surgery may offer additional benefit.