Minimally invasive sinus surgery is becoming a common option to treat chronic sinusitis, appearing to replace many nonsurgical alternatives such as antibiotic therapy, intranasal steroids and nasal saline irrigation. However, there is a lack of scientific data to show that surgery is a better option than medical therapies.
Chronic sinusitis is a condition that includes congestion, runny nose, headache, facial pressure and other symptoms lasting three months or more. It is a leading cause of doctor's office visits in the United States. Minimally invasive sinus surgery, in which small instruments and a lighted tube are inserted through the nose to remove abnormal tissue or obstructions, was introduced in the United States in 1985. Researchers at Dartmouth-Hitchcock Medical Center looked at the popularity of treatment of chronic sinusitis in a group of Medicare beneficiaries from 1998 to 2006. They found the rate of surgery increased 20% while the actual rate of the condition did not increase. The more traditional form of sinus surgery, open surgery, declined during that time.
The introduction of a minimally invasive surgery often increases interest in the surgical treatment of a problem, perhaps replacing medical treatments that might work just as well, the authors suggest.
"Endoscopic sinus surgery has been a revolutionary technology and has the potential to improve the poor quality of life of patients with rhinosinusitis with markedly less morbidity relative to open approaches," the authors wrote. But, they add, without long-term studies comparing surgery with medical treatments "the appropriate rate of endoscopic sinus surgery remains unknown."
The study was released Monday in the Archives of Otolaryngology, Head and Neck Surgery.
-- Shari Roan