In the May issue of 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," says the study's lead investigator, Alexander C. Chester, MD, a physician and clinical professor at Georgetown University Medical Center. Two other physicians from St. Louis University School of Medicine collaborated in the study.
Endoscopic sinus surgery is an extremely common procedure – about 200,000 procedures are performed each year – yet this is the first meta-analysis of symptom relief following the surgery, Chester says. It was conducted by examining 21 different published studies, which included 2,070 patients, analyzing improvement for each symptom.
"Reports of relative symptom relief vary across studies, so it was important to pool the study results. We wanted to know not only if symptoms improve overall, but if they improve to a similar degree, and if these benefits last," says Chester. "Our findings offer reassurance that, with minor exceptions, individual symptoms usually improve substantially and similarly following surgery."
Chester, an internist, says the study does not attempt to prove the effectiveness of endoscopic sinus surgery compared with medical treatment. "Only a randomized, controlled clinical trial testing surgery and medical therapy could prove that point."
But the findings will help patients weigh both the benefits and the risks of a surgical intervention, he says. "We now have the information we need to more accurately advise our patients," Chester says.
The type of surgery studied is typically done using endoscopic instruments, which allows surgeons to remove obstructions to drainage of the four sinus cavities. Older techniques are not so finely tuned to restoring natural function of the sinuses, Chester says.
The researchers assessed symptom relief using two 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 to before surgery. They found the following percentage improvements: 61 percent in facial pain, 59 percent in nasal obstruction, 53 percent in headache, 49 percent in smell, and 47 percent in postnasal discharge.
They also found that improvements do not decrease over time, as some smaller studies had suggested.
"We conclude that sinus surgery provides significant relief for most major sinus symptoms," Chester says.
Co-authors are senior investigator Raj Sindwani, MD, and Jastin Antisdel, MD. The authors report no potential financial conflicts. There was no funding for the study.
About Georgetown University Medical Center
Georgetown University Medical Center is an internationally recognized academic medical center with a three-part mission of research, teaching and patient care (through Georgetown's affiliation with MedStar Health). GUMC's mission is carried out with a strong emphasis on public service and a dedication to the Catholic, Jesuit principle of cura personalis -- or "care of the whole person." The Medical Center includes the School of Medicine and the School of Nursing and Health Studies, both nationally ranked, the world-renowned Lombardi Comprehensive Cancer Center and the Biomedical Graduate Research Organization (BGRO), home to 60 percent of the university's sponsored research funding.
Karen Mallet | EurekAlert!
Climate change and air pollution damaging health and causing millions of premature deaths
30.11.2018 | International Institute for Applied Systems Analysis (IIASA)
Reading rats’ minds
29.11.2018 | Institute of Science and Technology Austria
What if a sensor sensing a thing could be part of the thing itself? Rice University engineers believe they have a two-dimensional solution to do just that.
Rice engineers led by materials scientists Pulickel Ajayan and Jun Lou have developed a method to make atom-flat sensors that seamlessly integrate with devices...
Scientists at the University of Stuttgart and the Karlsruhe Institute of Technology (KIT) succeed in important further development on the way to quantum Computers.
Quantum computers one day should be able to solve certain computing problems much faster than a classical computer. One of the most promising approaches is...
New Project SNAPSTER: Novel luminescent materials by encapsulating phosphorescent metal clusters with organic liquid crystals
Nowadays energy conversion in lighting and optoelectronic devices requires the use of rare earth oxides.
Scientists have discovered the first synthetic material that becomes thicker - at the molecular level - as it is stretched.
Researchers led by Dr Devesh Mistry from the University of Leeds discovered a new non-porous material that has unique and inherent "auxetic" stretching...
Scientists from the Theory Department of the Max Planck Institute for the Structure and Dynamics of Matter (MPSD) at the Center for Free-Electron Laser Science (CFEL) in Hamburg have shown through theoretical calculations and computer simulations that the force between electrons and lattice distortions in an atomically thin two-dimensional superconductor can be controlled with virtual photons. This could aid the development of new superconductors for energy-saving devices and many other technical applications.
The vacuum is not empty. It may sound like magic to laypeople but it has occupied physicists since the birth of quantum mechanics.
10.12.2018 | Event News
06.12.2018 | Event News
03.12.2018 | Event News
10.12.2018 | Life Sciences
10.12.2018 | Physics and Astronomy
10.12.2018 | Life Sciences