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Endoscopic Sinus Surgery for Recurrent Acute Rhinosinusitis: A Randomized Clinical Trial.

Heidi Kaski^1,2, Antti Alakärppä^1,2, Aleksi Laajala^1,2

¹Department of Otorhinolaryngology and Head and Neck Surgery, Oulu University Hospital, Oulu, Finland.

JAMA Otolaryngology-- Head & Neck Surgery

|June 18, 2026

Summary

Endoscopic sinus surgery (ESS) significantly improved quality of life for patients with recurrent acute rhinosinusitis (RARS) compared to medical treatment alone over 6 months. ESS is an effective treatment option for RARS.

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Area of Science:

Otolaryngology
Surgical Innovation
Patient Outcomes

Background:

Recurrent acute rhinosinusitis (RARS) significantly impairs patients' quality of life.
The efficacy of endoscopic sinus surgery (ESS) for RARS remains understudied.
Conservative treatments often provide insufficient symptom relief for RARS patients.

Purpose of the Study:

To compare the quality of life in RARS patients undergoing ESS plus medical treatment versus medical treatment alone.
To evaluate the impact of ESS on sinonasal symptoms and healthcare utilization in RARS.

Main Methods:

An open-label randomized clinical trial involving 59 adult RARS patients.
Participants were randomized to receive either ESS plus medical treatment or medical treatment alone.
Quality of life was assessed using the SinoNasal Outcome Test 22 (SNOT-22) at a 6-month follow-up.

Main Results:

Patients receiving ESS showed a significantly greater improvement in mean SNOT-22 scores (22.41 points) compared to the medical treatment group.
Secondary outcomes largely supported the primary findings, indicating broader benefits of ESS.
The operative group experienced a low rate of complications, with only 4 patients requiring intervention.

Conclusions:

Endoscopic sinus surgery (ESS) demonstrably improves patient-reported outcomes in adults with RARS at 6 months.
Medical treatment alone showed no clinically meaningful effect on quality of life for RARS patients.
ESS is presented as an effective and safe treatment option for RARS, with minimal complications.