4
Key Action Statements
Table 2. Summary of Guideline Key Action Statements (KAS)
(cont'd)
Statement Action Grade
KAS 7. Imaging in
candidates for
sinus surgery
For an adult who is a candidate for
sinus surgery, the surgeon or their
designee should obtain a computed
tomography (CT) scan with a fine-cut
protocol, if not already available, to
examine the paranasal sinuses for
surgical planning.
Recommendation
KAS 8. Avoid arbitrary
criteria for
mucosal
thickening
e surgeon should not plan the extent
of sinus surgery (e.g., which specific
sinuses to operate on) solely based on
arbitrary criteria regarding a minimal
level of mucosal thickening, sinus
opacification, or outflow obstruction
on a CT scan.
Recommendation
KAS 9. Education about
postoperative care
expectations
e surgeon or their designee should
educate an adult with chronic
rhinosinusitis who is scheduled for
sinus surgery regarding anticipated
postoperative care, specifically pain
control, debridement, medical
management, activity restrictions,
return to work, duration and frequency
of follow-up visits, and the potential for
recurrent disease or revision surgery.
Recommendation
KAS 10. Extent of sinus
surgery
When the sinus involves polyps, osteitis,
bony erosion, or fungal disease in an
adult with chronic rhinosinusitis who is
scheduled for sinus surgery, the surgeon
should perform sinus surgery that
includes full exposure of the sinus cavity
(lumen) and removal of diseased tissue,
not just balloon or manual ostial dilation,
or refer the patient to a surgeon who can
perform this extent of surgery.
Recommendation
KAS 11. Outcome
assessment
and long-term
follow-up
e surgeon or their designee should
follow up to assess outcomes of sinus
surgery for chronic rhinosinusitis,
between 3 and 12 mo aer the
procedure, through history (symptom
relief, quality of life, complications,
adherence to therapy, need for rescue
medications, and ongoing care) and nasal
endoscopy.
Recommendation
