SNOT-22 scores were significantly lower in endoscopic surgery group versus clarithromycin and placebo groups
THURSDAY, Sept. 4, 2025 (HealthDay News) — For patients with chronic rhinosinusitis, endoscopic sinus surgery improves disease-specific quality of life at six months, according to a study published online Aug. 30 in The Lancet.
Carl Philpott, M.D., from the University of East Anglia in the United Kingdom, and colleagues conducted a pragmatic, three-arm placebo-controlled, phase 4 trial to compare the clinical effectiveness of endoscopic sinus surgery or three months of clarithromycin treatment alongside intranasal medication in adults with chronic rhinosinusitis with or without nasal polyps. A total of 410 adults with chronic rhinosinusitis with nasal polyps and 104 with chronic rhinosinusitis without nasal polyps were recruited and randomly assigned to receive endoscopic sinus surgery, clarithromycin (250 mg twice daily for two weeks followed by 250 mg once daily for 10 weeks), or placebo, all with intranasal medication (171, 172, and 171, respectively). The primary outcome measure was the total score on the 22-item Sino-Nasal Outcome Test (SNOT-22) quality-of-life questionnaire at six months after randomization.
The researchers found that at six months after randomization, SNOT-22 scores were significantly lower in the endoscopic surgery group versus the clarithromycin group and placebo group (adjusted mean difference, –18.13 and –20.44, respectively). No significant difference was seen in six-month SNOT-22 scores for those randomly assigned to clarithromycin or placebo.
“What we found is that surgery was effective at reducing symptoms six months on, while taking the course of antibiotics seemed to make little difference,” Philpott said in a statement. “Until now, there was no evidence in the form of a trial that showed sinus surgery works better than medical treatment, and access to sinus surgery has been restricted in some parts of the U.K. in recent years. This could be a real game-changer for sufferers worldwide.”
Several authors disclosed ties to the pharmaceutical and medical device industries.
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