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Chronic rhinosinusitis (CRS), or sinusitis, is a long-term condition affecting one in 10 UK adults. Symptoms include a blocked and runny nose, loss of smell, facial pain, tiredness and worsening of breathing problems, such as asthma. It’s often similar to the symptoms of a bad cold, but it can last for months or even years.
The team carried out a randomised controlled patient trial comparing sinus surgery with long-term use of antibiotics, and a placebo drug.
More than 500 patients took part from around the UK, and all of them used nasal steroids and saline rinses as part of their usual care – both of which have been shown to help the condition.
The researchers found that surgery was most effective at relieving sinusitis symptoms, and trial participants were still feeling better six months later, according to the findings published in The Lancet. Of those who underwent surgery, 87% said their quality of life had improved six months on.
A three-month course of low dose antibiotics was not found to be helpful as there was no significant difference in outcomes between those on antibiotics and those in the placebo arm of the trial.
The study is part of the MACRO programme, involving a collaborative group of researchers from UCL (the trial’s sponsor), the University of Oxford, the University of East Anglia (UEA), Guy’s and St Thomas’ NHS Foundation Trust, the University of Southampton, UCLH, and Imperial College London. The programme is funded by the National Institute for Health and Care Research.