Patient perspectives on sinus surgery

Investigators may have uncovered attitudes toward endoscopic sinus surgery among patients with chronic rhinosinusitis.

In a study published in BMJ Open, the investigators examined the experiences of patients with chronic rhinosinusitis and clinical staff who participated in the MACRO trial, in which patients were randomly assigned to undergo endoscopic sinus surgery or receive clarithromycin or placebo across 21 secondary and tertiary ear, nose and throat centers in England and Scotland.

Compared with clarithromycin and placebo — which demonstrated comparable results — endoscopic sinus surgery was found to be effective in treating chronic rhinosinusitis. Following interviews with 20 of the patients and 17 clinical staff at six months, the investigators were able to better understand the participants’ experiences. For instance, the patients who underwent the endoscopic sinus surgery reported rapid symptom improvements, including greater nasal airflow, reduced facial pain and better sense of smell. However, they more commonly experienced challenges such as postsurgical pain, congestion, bleeding, prolonged recovery and infections. While some patients viewed sinus surgery as the next step in the management of chronic rhinosinusitis, others posed concerns over the surgical risks, recovery period and the procedure’s impact on work.

To increase uptake of endoscopic sinus surgery and address patient hesitancy, the investigators emphasized that clinicians should communicate the risks and benefits of the procedure clearly and acknowledge patient preferences. Implementation could depend on support for shared decision-making and health care resources to enhance surgical care.

Read more: BMJ Open

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