Chronic rhinosinusitis, also called chronic sinusitis, is a very common life-long disease affecting at least 5% of the Canadian population. Its symptoms, including daily facial pain and headache, an inability to breath through the nose and partial or complete smell loss, regularly impair one’s ability to work and to enjoy and participate in daily activities.
Chronic sinusitis with polyps, the most common type of chronic sinusitis, is usually treated with a combination of medications and surgery. Until now, surgical treatment has only been performed in the operating room, at a cost of about $3500 per procedure to the healthcare system. But, recent Canadian studies have shown that a recently developed procedure, endoscopic polypectomy in clinic (EPIC) or “in-clinic polyp removal”, can provide an improvement in patient symptoms to levels equal to those for sinus surgery performed in a hospital operating room. Moreover, in clinic polyp removal has additional advantages including a shorter recovery time after the treatment, a significantly lower cost to the health care system (about one-tenth the cost or $450), and a shorter wait time for treatment. A patient who underwent the EPIC procedure was recently interviewed by CTV news (see the link here: http://ottawa.ctvnews.ca/procedure-helps-ottawa-man-regain-sense-of-smell-taste-1.2726503 )
Can the EPIC procedure replace sinus surgery done in the operating room for some patients with chronic sinusitis with polyps? A national multi-center Canadian trial is currently planned and awaiting a funding decision in order to determine the answer to this question. If the trial is successfully funded, the answer to this question should be known in the next 2 years. We will then know if this recently developed treatment approach, in clinic polyp removal (EPIC), can replace sinus surgery as the standard of care for these patients.
Prepared by: Shaun Kilty, MD, Assistant Professor, University of Ottawa
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