title: Evidence-based surgery for chronic rhinosinusitis with and without nasal polyps.
abstract: Meta-analysis of both large outcome studies as well as cohort studies support the safety and efficacy of Endoscopic Sinus Surgery for Chronic Rhinosinusitis. The efficacy of endoscopic sinus surgery is demonstrated in the improvement of both disease-specific and generic QOL as well as objective measures. However, this must be interpreted together with a well-recognized long-term 15-20 % revision rate, seen more often in patients with ASA trias and cystic fibrosis as well as osteitis and previous surgery. The effect of surgery is higher in managing nasal obstruction (effect size 1.7) and less so hyposmia (effect size 0.8). Allergy has an additive role on the symptomatology of CRS; however, its role if any on the outcome of ESS for CRS is unclear. The concurrent presence of aspiring sensitivity and asthma is associated with increased disease burden and more revision surgeries. Improved phenotyping of CRS may lead in the future to better tailoring of surgical treatments.
authors.affiliation: Department of Otorhinolaryngology, Academic Medical Centre, A2-228, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands, c.georgalas@amc.nl.
authors.forename: Christos
authors.initials: C
authors.lastname: Georgalas
authors.forename: Marjolein
authors.initials: M
authors.lastname: Cornet
authors.forename: Gwijde
authors.initials: G
authors.lastname: Adriaensen
authors.forename: Susanne
authors.initials: S
authors.lastname: Reinartz
authors.forename: Carlijn
authors.initials: C
authors.lastname: Holland
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Prokopakis
authors.forename: Wytske
authors.initials: W
authors.lastname: Fokkens
mesh_terms: D002908:Chronic Disease; D004724:Endoscopy; D006801:Humans; D009298:Nasal Polyps / Q000150:complications / Q000601:surgery*; D010256:Paranasal Sinuses / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D012220:Rhinitis / Q000150:complications / Q000601:surgery*; D012852:Sinusitis / Q000150:complications / Q000601:surgery*