19
Cost
Benefit-Harm
Assessment Policy Level
Low additional cost to
achieve target MAP
Preponderance of
benefit over harm
Option: Controlled
hypotension (MAP between
60 and 70 mmHg ) is safe and
improves the surgical field
Ignorance of individual
specific symptoms or
loss of productivity
at work if criteria for
surgery not met
Likely benefit over harm
with acknowledgement
that certain patients with
low SNOT-22 may still
benefit from surgery
Option: Patient selection for
surgical intervention should
take into consideration baseline
patient-reported symptom
burden
Balloon-dilation
technolog y is associated
with increased
equipment costs per
case
In short term follow-up,
conservative approaches
do not appear to increase
harm from recurrence
in patients with limited
sinus disease
Option: Less extensive sinus
interventions are likely
reasonable options in patients
with minimal OMC or
maxillary sinus disease
Costs related to longer
operating time and the
need for specialized
equipment
Preponderance of
benefit over harm in
selected cases
Option: Use in patients
undergoing ESS, especially
in the setting of anatomic
complexity or the need for more
advanced procedures
