Comparative Effectiveness of Endoscopic Sinus Surgery Versus Medical Therapy on Olfactory Function in Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis

Nur Alma Aulia; Widia Isa Aprillia  Sujana

doi:10.33192/smj.v78i10.283458

Authors

Nur Alma Aulia Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
Widia Isa Aprillia Sujana Department of Otorhinolaryngology, Faculty of Medicine, Universitas Katolik Widya Mandala, Surabaya, Indonesia

DOI:

https://doi.org/10.33192/smj.v78i10.283458

Keywords:

chronic rhinosinusitis, endoscopic sinus surgery, medical therapy, olfactory dysfunction, meta-analysis

Abstract

Objective: This study aimed to compare the effectiveness of ESS versus medical therapy in improving olfactory function among adult patients with CRS.

Materials and Methods: A systematic review and meta-analysis were conducted using PubMed, Cochrane Library, and ScienceDirect. Comparative studies evaluating ESS and medical therapy with reported olfactory outcomes were included. Standardized mean differences (SMD) were calculated using a random-effects model. Outcomes were orientated such that higher values indicated better olfactory function.

Results: Four studies were included in the qualitative synthesis, with three studies (n = 163) eligible for quantitative meta-analysis. The pooled analysis demonstrated a statistically significant improvement favoring ESS over medical therapy alone (SMD = 1.02, 95% CI: 0.26 to 1.78; p = 0.009), though substantial statistical heterogeneity was observed (I² = 75%). Individual studies showed variable results across outcome metrics. Despite this statistical difference, the differences between objective psychophysical testing and subjective self-reported measures.

Conclusion: Evidence regarding the comparative effectiveness of ESS versus medical therapy in improving olfactory function remains highly uncertain. Given the methodological limitations of current data, further high-quality, well-phenotyped trials are required to clarify relative treatment efficacy.

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