Clinical Report: Full vs Limited FESS Tested in CRSwNP

Overview

Both full and limited functional endoscopic sinus surgery (FESS) resulted in significant improvements in disease-specific health-related quality of life over 24 months for patients with uncontrolled chronic rhinosinusitis with nasal polyps. However, the difference in improvement between the two surgical approaches did not reach the minimal clinically important difference.

Background

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a prevalent condition that significantly impacts patients' quality of life. Surgical intervention, such as functional endoscopic sinus surgery (FESS), is often required for patients who do not respond to medical management. Understanding the efficacy of different surgical approaches is crucial for optimizing treatment outcomes in this patient population.

Data Highlights

Key Findings

• Both full and limited FESS showed improvements in SNOT-22 scores at 12 and 24 months.
• Mean SNOT-22 scores decreased by approximately 30 points for full FESS and 25 points for limited FESS at 12 months.
• Nasal polyp scores decreased more significantly in the full FESS group over the follow-up period.
• Olfactory function improved in both groups, with greater recovery from anosmia in the full FESS group.
• 41% of patients in the full FESS group had anosmia at 12 months compared to 76% in the limited FESS group.
• Both groups experienced a decrease in the number of oral corticosteroid courses during the 24-month follow-up.

Clinical Implications

The findings suggest that while both surgical approaches improve quality of life, the choice between full and limited FESS may not significantly impact overall outcomes. Clinicians should consider individual patient factors when determining the extent of surgery.

Conclusion

Full and limited FESS both provide clinically meaningful improvements in patients with CRSwNP, but the lack of a significant difference in outcomes suggests that either approach may be appropriate depending on individual patient circumstances.

Related Resources & Content

1. Virkkula P, Allergy, 2026 -- Efficacy of Full and Limited Endoscopic Sinus Surgery in Chronic Rhinosinusitis With Nasal Polyps: A Randomised Controlled Trial
2. Shin, Otolaryngology–Head and Neck Surgery, 2025 -- Clinical Practice Guideline: Surgical Management of Chronic Rhinosinusitis
3. Evaluating the Role of Flexible and Navigable Suction Access Sheath (FANS) in Patients Undergoing Concurrent Flexible Ureteroscopy for Bilateral Kidney Stones: A Global Prospective Multicenter Study by EAU Endourology
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6. Surgical Endoscopy — Comparative Analysis of Safety and Effectiveness Between Conventional and Segmented Fully Covered Self-Expanding Metal Stents for Esophageal Strictures: A Retrospective Multicenter Case-Control Investigation
7. Clinical Practice Guideline: Surgical Management of Chronic Rhinosinusitis - Shin - 2025 - Otolaryngology–Head and Neck Surgery - Wiley Online Library
8. Efficacy of Full and Limited Endoscopic Sinus Surgery in Chronic Rhinosinusitis With Nasal Polyps: A Randomised Controlled Trial - Virkkula - Allergy - Wiley Online Library
9. Extent of Endoscopic Sinus Surgery in Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis - PubMed