CRS Trial Reveals Surgery Divide

MACRO qualitative study explores why patients differ in attitudes toward endoscopic sinus surgery.

Category	Detail
Condition	Chronic Rhinosinusitis (CRS)
Key Mechanisms	Chronic inflammatory condition affecting nasal and paranasal sinus mucosa.
Target Population	Patients with CRS, including those with and without nasal polyps.
Care Setting	Secondary and tertiary ear, nose, and throat centers.

Endoscopic sinus surgery (ESS) showed greater improvement in Sino-Nasal Outcome Test–22 scores compared to clarithromycin or placebo.
Patients often sought additional options after exhausting standard medical therapies.
Postoperative experiences varied, with some patients reporting rapid symptom relief and others facing complications.
Gastrointestinal symptoms were the most common adverse effects of clarithromycin.
Implementation of trial findings may face barriers such as surgical waiting lists and patient hesitancy.

Assess symptoms including nasal obstruction, rhinorrhea, facial pain, and anosmia.

Consider endoscopic sinus surgery for patients with persistent symptoms despite medical therapy.

Discuss surgical risks, postoperative recovery, and potential complications with patients.

Patients with chronic rhinosinusitis, particularly those with nasal polyps.

ESS provides rapid symptom relief, while clarithromycin shows limited benefit.

Facilitate shared decision-making with patients regarding treatment options.
Ensure clear communication about the benefits and risks of surgical interventions.
Address potential barriers to implementation of surgical care.