This open-label RCT compared ESS plus medical treatment vs. medical treatment alone in 59 adults with recurrent acute rhinosinusitis (RARS) — defined as ≥3 episodes in 6 months, ≥4 in a year, or ≥2/year for 3 consecutive years — over a 6-month follow-up at a single Finnish tertiary center.
ESS produced a 22.41-point greater improvement in SNOT-22 score vs. medical treatment alone (95% CI, 13.67–31.10 points); conservative treatment showed no clinically meaningful effect. Only 4 patients required intervention for operative complications (3 infections, 1 synechia with septal perforation).
Small sample (n=59) at a single center limits generalizability; follow-up was only 6 months, leaving long-term durability unknown; the study population was 88% female, which may limit applicability to male patients.
For adults with RARS uncontrolled by conservative measures, ESS provides a clinically meaningful improvement in sinonasal quality of life within 6 months. Medical management alone appears insufficient for this population, and the complication rate was low.
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