Updated Clinical Guidelines for Surgical Treatment of Chronic Rhinosinusitis in Adults

A new set of clinical practice guidelines has been released by the American Academy of Otolaryngology-Head and Neck Surgery Foundation, offering comprehensive recommendations for the surgical management of chronic rhinosinusitis in adult patients. Published online on May 27 in Otolaryngology-Head and Neck Surgery, these guidelines aim to assist clinicians in making evidence-based decisions to improve patient outcomes.

Led by Dr. Jennifer J. Shin from Harvard Medical School, a panel of experts formulated 11 key action statements. These emphasize the importance of confirming a diagnosis of chronic rhinosinusitis prior to considering surgery. Notably, they advise against mandating a specific medical therapy regimen or trial duration before opting for surgical intervention. Patients with certain subtypes of rhinosinusitis—such as those with nasal polyps, polyps with bony erosion, eosinophilic mucin, or fungal balls—are highlighted as ideal surgical candidates who might benefit more from operative procedures than continued medical therapy.

The guidelines stress the importance of setting realistic expectations through thorough preoperative counseling. Patients should be informed about the potential for ongoing symptoms or disease recurrence, and the likelihood of requiring long-term medical management. Before surgery, a detailed computed tomography (CT) scan with fine-cut protocols is recommended to assess the sinuses and guide surgical planning. The extent of surgery should not be based solely on arbitrary imaging criteria like mucosal thickening or sinus opacification but should be tailored to individual patient anatomy and disease presentation.

Furthermore, patient education regarding postoperative care, including pain management, is essential. Dr. Shin emphasizes that these guidelines aim to streamline care pathways and support clinicians in delivering optimal treatment based on the latest evidence.

For more detailed information, consult the full guideline: DOI: 10.1002/ohn.1287. The guidelines are part of ongoing efforts to standardize and improve the surgical management of chronic rhinosinusitis in adults.

[Source: https://medicalxpress.com/news/2025-06-guidelines-issued-surgical-chronic-rhinosinusitis.html]