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Table 5. Concepts To Evaluate If Considering Endoscopic
Surgery on a Sinus without Radiologic Evidence
of Disease in a Patient Who Meets Guideline-
Established Criteria for a Diagnosis of CRS and
aProcedural Intervention
Reasons for performing ESS on a sinus without radiologic evidence of disease
a
e sinus is interposed between two radiologically diseased sinuses, and not addressing
the radiologically nondiseased sinus could compromise ESS to, or postoperative topical
medication delivery to, the two radiologically diseased sinuses.
e nature of the patient's CRS puts them at high risk for recurrence and need for
addressing the sinus (with no radiologic evidence of disease currently) in revision ESS,
when postoperative osteitic changes to that sinus may put the patient at higher risk.
e radiologically diffuse nature of the patient's sinus disease suggests that a sinus
without radiologic evidence of disease is likely to have active CRS.
ESS on adjacent sinuses may put the postoperative function of the radiologically
nondiseased sinus at risk, for example, due to scarring.
a
ese concepts and this key action statement do not condone surgery on patients with normal sinus
computed tomography scans.
