Sinus Surgery: When Is Earlier Intervention Beneficial?

Research is showing the effects of earlier surgical referral for patients with chronic rhinosinusitis.

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Chronic rhinosinusitis can substantially impair quality of life, with social functioning scores lower than those for most other chronic diseases.
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In the 2025 MACRO trial, endoscopic sinus surgery reduced SNOT-22 scores by 20.44 points more than placebo at 6 months, exceeding the 8.9-point minimum clinically important difference.
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The MACRO trial found no significant benefit of clarithromycin over placebo when both groups received intranasal corticosteroids and saline irrigations.
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A UK retrospective analysis found that patients who waited at least 5 years for surgery had greater postoperative health care utilization than those treated within 12 months of diagnosis.
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Endoscopic sinus surgery is performed through the nostril, and most patients go home the same day and return to normal activities within about 1 week.

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