Title: Comparison of Outcomes of Management of Chronic Rhinosinusitis by Conservative Approach Vs Endoscopic Sinus Surgery with Review of Literature
Author: Dr Devendra M. Jain
DOI: https://dx.doi.org/10.18535/jmscr/v5i3.165
Abstract
Chronic rhinosinusitis (CRS) affects 1 in 8 people in India; about 5-15% of urban population. The prevalence of sinusitis (146/1000 population) has been reported to exceed that of any other chronic condition and is apparently on the increase. Sinusitis is a common health problem that leads to frequent visits to primary care physicians and to ear, nose and throat specialists in all over the world. It contributes to a significant amount of health care expenditure due to direct costs arising from physician visits and antibiotics, as well as indirect costs related to missed days at work and a general loss of productivity due to a decrease in life-quality of those affected.
Many medical & surgical therapies have been used to treat CRS. Medical therapy includes antimicrobials, corticosteroids, decongestants, antihistamines, mast cell stabilizers, antileukotr-ienes, nasal douching, immunotherapy, and reduction of environmental factors. The documentation of medical treatment of CRS is deficient in the literature, apart from a few randomized, controlled trials investigating the role of corticosteroids in CRS with nasal polyposis.
On the other hand, Endoscopic sinus surgery has yielded excellent subjective and objective outcomes, with a very low complication rate. The high success rate, the low incidence of complications and the technological advances in optical instrumentation and imaging techniques in the presence of poor documentation of outcomes of medical therapy has made endoscopic sinus surgery the primary therapy for CRS in the absence of a well performed, prospective, randomized, controlled trial that fulfills level I statement of evidence based medicine. To address this deficiency, the present study has been designed to evaluate and compare surgical and medical treatment of CRS.
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