Millions with chronic sinusitis may benefit from surgery, study suggests

Millions with chronic sinusitis in UK could soon be offered surgery

Millions of people suffering from chronic sinusitis may soon be offered surgery to improve their breathing and quality of life, according to a new study published in The Lancet.

Chronic rhinosinusitis (CRS) affects around one in ten adults and causes inflammation of the nose and sinuses, leading to nasal congestion, facial pain, and long-term breathing difficulties. While often mistaken for a persistent cold, CRS can last for months or even years, severely impacting daily life and work productivity.

Currently, patients are prescribed nasal steroids and saline rinses, but a major clinical trial suggests that these treatments are broadly ineffective compared to surgery.

Study findings highlight effectiveness of sinus surgery

Researchers from University College London, the University of East Anglia, and Guy’s and St Thomas’ NHS Foundation Trust conducted one of the largest trials to date, involving more than 500 patients with CRS.

All participants received nasal steroids and saline rinses as standard care. They were then randomly allocated either sinus surgery, antibiotics, or placebo tablets.

Key results from the trial include:

• 87% of patients who underwent sinus surgery reported significant improvement in their quality of life after six months.
• Antibiotics showed little to no benefit compared with surgery.
• Nasal steroids and rinses alone did not provide substantial long-term relief.
• Professor Carl Philpott, lead author and rhinology specialist at the University of East Anglia, said:

“Until now, there was no clinical trial evidence showing that sinus surgery works better than medical treatment. These findings are a potential game-changer for sufferers worldwide.”

Why this matters for patients and the NHS

Experts suggest that these results could help reduce delays in treatment, ease the burden on healthcare resources, and improve patient care pathways. Professor Claire Hopkins, a rhinology specialist at Guy’s Hospital, London, noted that restricted access to sinus surgery within the NHS has limited options for many patients. She emphasized that this study provides strong evidence to support surgery as a reliable treatment option.

Risks of overusing nasal sprays

Doctors have also warned about the overuse of nasal decongestant sprays such as Sudafed. Although effective for temporary relief, prolonged use can cause rebound congestion and worsen sinusitis symptoms. Experts are calling for stricter regulation, with suggestions that these sprays should be available only via prescription.

The future of chronic sinusitis treatment

The trial demonstrates that sinus surgery offers significant and lasting benefits compared with medical management. Researchers will continue to study patients over a longer period to confirm the durability of these outcomes.

For millions living with chronic sinusitis, this research offers new hope for effective and lasting relief.

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