Rhinosinusitis - surgical intervention for chronic rhinosinusitis

For the treatment of

Chronic rhinosinusitis (CRS)

Commissioning position

This intervention is only commissioned if the following criteria have been met:

  • Moderate/severe symptoms (assessed using Sinonasal Outcome Test (SNOT-22)) persist after at least 3 months of conservative treatment (in accordance with the ENT UK guidance) in Primary Care
  • Alternative diagnoses than CRS are considered to have been excluded by the specialist

Lund Mackay (LM) score of CT imaging is >4

Summary of rationale

Conservative treatment is effective for many people with Chronic rhinosinusitis.

 

CT scan is mandatory before surgery but does not require repeating if performed earlier in the pathway. If LM score is <4 alternative diagnosis should be considered, and endoscopic sinus surgery is not usually indicated.

References

EBI Surgical intervention for chronic rhinosinusitis (AOMRC)

Rhinosinusitis commissioning guide (ENT UK)

European Position Paper on Rhinosinusitis and Nasal Polyps 2020

Associated Pathways

There are no associated pathways.

Specialties

Ear, Nose and Throat York Ear, Nose and Throat North Yorkshire Ear, Nose and Throat Hull Ear, Nose and Throat East Riding Ear, Nose and Throat North Lincolnshire Ear, Nose and Throat North East Lincolnshire

Places covered by

  • east-riding
  • hull
  • north-east-lincolnshire
  • north-lincolnshire
  • north-yorkshire
  • vale-of-york
Author:
Date created: 11/06/2025, 11:37
Last modified: 15/07/2025, 15:05
Date of review: 31-01-2028