Minimally invasive sinus surgery becoming more common in medicare population

May 17, 2010

Sinus surgery performed using an endoscope appears to be increasingly common for the management of chronic sinus disease among Medicare beneficiaries, according to a report in the May issue of Archives of Otolaryngology-Head & Neck Surgery.

Chronic rhinosinusitis is characterized by infection and inflammation of the sinus cavities and nose that lasts longer than three months, according to background information in the article. Symptoms include congestion, runny nose, headache, facial pressure and loss of smell. "Mainstays of medical management for sinusitis include antibiotic therapy, systemic and topical intranasal steroids and nasal saline irrigations," the authors write. "A subset of patients with chronic rhinosinusitis in whom medical management fails undergo surgery, sometimes repeatedly, for treatment of their disease."

Endoscopic sinus surgery, a minimally invasive technique, was introduced in the United States in 1985, the authors note. To examine trends in rates of the procedure, Giridhar Venkatraman, M.D., M.B.A., of Dartmouth-Hitchcock Medical Center, Lebanon, N.H., and colleagues studied a sample of beneficiaries age 65 to 99.

From 1998 to 2006, the rate of beneficiaries diagnosed with chronic rhinosinusitis declined by 1.4 percent. However, the rate of endoscopic sinus surgery increased 20 percent, from 0.72 per 1,000 patients to 0.92 per 1,000 patients. Over the same time, open sinus surgery rates declined 40 percent, from 0.20 per 1,000 patients to 0.11 per 1,000 patients.

When the researchers analyzed patients by age group—ages 65 to 69, 70 to 74, 75 to 79, 80 to 84 or 85 and older—the per capita rate of chronic sinusitis diagnoses remained the same. However, all age groups had increases in endoscopic sinus surgery rates.

"Our findings indicate that endoscopic sinus surgery is increasingly becoming the mainstay of chronic rhinosinusitis management in the Medicare population," the authors write. "Because of the uncertainty regarding the outcomes of surgical vs. medical management, the root causes of the observed increase in endoscopic rates need to be investigated. Given that sinusitis is a common diagnosis necessitating physician visits, comparative effectiveness studies examining medical vs. surgical management would be warranted."

Explore further: Face transplants change lives, identity

More information: Arch Otolaryngol Head Neck Surg. 2010;136[5]:426-430.

add to favorites email to friend print save as pdf

Related Stories

Surgery helps chronic sinusitis sufferers get relief

Jan 27, 2010

Adults with chronic rhinosinusitis —a debilitating inflammation of the nasal passages that lasts for months and keeps coming back — report significantly improved quality of life following minimally invasive endoscopic ...

Recommended for you

Face transplants change lives, identity

19 hours ago

Patients are prepared to take significant risks in order to be considered for a face transplant, says Dr David Koppel, director of the largest craniofacial unit in the UK and Honorary Clinical Associate Professor ...

British Lords hold ten-hour debate on assisted dying

Jul 19, 2014

Members of Britain's unelected House of Lords spent almost ten hours on Friday discussing whether to legalise assisted dying, in an often emotional debate putting the question back on the agenda, if not on the statute books.

User comments : 1

Adjust slider to filter visible comments by rank

Display comments: newest first

LuckyBrandon
not rated yet May 18, 2010
I need this surgery BAD

But I am curious as to why this has its own article...seems more like something for a side note in a more thorough article...