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Diseases of the Sinuses pp 449–463Cite as

Controversies in the Surgical Management of Chronic Rhinosinusitis

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Abstract

Surgical treatments for chronic rhinosinusitis are generally reserved for those patients who have failed to respond to medical treatment. Does evidence support surgical intervention in chronic rhinosinusitis? Indeed what is ‘surgical’ rhinosinusitis?

There is rightly a move towards evidence-based medicine, and we should all strive towards evidence-based surgical practice. However, this can be more difficult to achieve in surgical than in medical disciplines.

Also, lack of evidence does not necessarily mean lack of efficacy.

The introduction of new technologies and innovation is regulated, though this is often to ensure safety rather than best treatment. The uptake of new technologies and tools varies, and their uptake may sometimes be associated with their potential use as a marketing tool.

What is the Cochrane Collaboration and what are Cochrane Reviews?

What is the current evidence supporting the use of functional endoscopic sinus surgery, external approach sinus surgery, image guidance, balloon sinuplasty and surgical intervention in paediatric chronic rhinosinusitis?

We should strive to increase the surgical evidence base to help determine and support appropriate surgical interventions in chronic rhinosinusitis but whilst accepting that RCTs in surgery are difficult.

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Author information

Authors and Affiliations

  1. Department of ENT Surgery, Barts Health NHS Trust, Whipps Cross University Hospital, Whipps Cross Road, London, E11 1NR, UK

    Samuel Jayaraj MBBS, FRCS(Eng), FRCS(ORL-HNS)

  2. Department of ENT Surgery, University College London Hospital, Royal National Throat Nose and Ear Hospital, 330 Grays Inn Road, London, wc1x 8da, UK

    Peter James Andrews MBBS, BSc (hons) FRCS (ORL-HNS)

Authors
  1. Samuel Jayaraj MBBS, FRCS(Eng), FRCS(ORL-HNS)
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  2. Peter James Andrews MBBS, BSc (hons) FRCS (ORL-HNS)
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Corresponding author

Correspondence to Samuel Jayaraj MBBS, FRCS(Eng), FRCS(ORL-HNS) .

Editor information

Editors and Affiliations

  1. Division of Allergy and Immunology, Department of Pediatrics, Thomas Jefferson University, Wilmington, Delaware, USA

    Christopher C. Chang

  2. Division of Rheumatology, Allergy and Clinical Immunology, University of California School of Medicine, Davis, California, USA

    Gary A. Incaudo

  3. The Jack and Donald Chia Distinguished Professor of Medicine, Division of Rheumatology, Allergy and Clinical Immunology, University of California School of Medicine, Davis, California, USA

    M. Eric Gershwin

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Jayaraj, S., Andrews, P.J. (2014). Controversies in the Surgical Management of Chronic Rhinosinusitis. In: Chang, C., Incaudo, G., Gershwin, M. (eds) Diseases of the Sinuses. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-0265-1_24

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  • DOI: https://doi.org/10.1007/978-1-4939-0265-1_24

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