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โ† Trials
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In-clinic Endoscopic Polypectomy for Chronic Sinusitis With Nasal Polyps

RecruitingNAAges 18 Years - anyAllOttawa Hospital Research Institute
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In plain words

What the trial is, and whether it could suit you

Chronic rhinosinusitis, also called chronic sinusitis, is a very common life-long disease affecting over 5% of the Canadian population. Its symptoms, including daily facial pain and headache, an inability to breath through the nose and complete smell loss, regularly impair one's ability to work and to enjoy and participate in daily activities. The annual cost of chronic sinusitis to Canada is estimated at $1.3 billion while the government pays an estimated $860 million yearly for chronic sinusitis treatment. 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. But, recent studies have shown that a new procedure, "in-clinic polyp removal", can provide an improvement in patient symptoms to

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๐Ÿ“‹ Eligibility rules (as published)
Inclusion Criteria: 1. Age 18 years or older 2. Diagnosis of chronic rhinosinusitis with polyps requiring surgical treatment after having been treated with medical therapy as designated by the Canadian clinical practice guidelines for acute and chronic sinusitis. 15 3. Bilateral nasal polyps present of Grade โ‰ฅ 2 on each side as determined by the Lildholdt scale score measured by nasal endoscopy at the screening visit. 4. Must have nasal blockage score greater than or equal to 2 on the sinonasal outcome test SNOT-22 at the screening visit. 5. Must have an American Society of Anesthesiologists physical status PS3 classification or less. 6. Participants with comorbid asthma or chronic obstructive pulmonary disease (COPD) must have stable disease with no exacerbations (no emergency room visits, hospitalisations, or oral or parental steroid use for these lower respiratory conditions) within 3 months before the screening visit. 7. Must be capable, in the opinion of the investigator, of providing informed consent to participate in the study. Participants must sign an informed consent document indicating that they understand the purpose of and procedures of the study and are willing to participate in the study. Exclusion Criteria: 1. Women who are pregnant or breast feeding as per patient's report 2. Patients with hyperplastic polyps or polyps large enough that they result in external nasal deformity 3. Facial pain/pressure score higher than 2 on the sinonasal outcome test SNOT-22 at the screening visit. 4. History of any surgical procedure that prevents the ability to accurately grade the nasal polyps 5. Participants who will not be able to complete the follow-up appointments/evaluations 6. Have significant oral structural abnormalities, e.g. unrepaired cleft palate 7. Septal deviation requiring correction in order to perform either EPIC or ESS procedures 8. Diagnosis of an immunodeficiency or immunocompromised state 9. Diagnosis of cystic fibrosis 10. Diagnosis of allergic fungal sinusitis 11. Contraindication to the use of oral corticosteroids (e.g. uncontrolled diabetes, congestive heart failure, uncontrolled hypertension, known renal insufficiency, known peptic ulcer disease, known glaucoma, pregnancy) 12. History of either Churg-Strauss syndrome, primary ciliary dyskinesia, or vasculitis (e.g. granulomatosis with polyangiitis(GPA)) 13. Allergy, hypersensitivity, or contraindication to the use of local or topical lidocaine anesthetics, nasal topical 1:1000 adrenaline, nasal decongestants, nasal steroid spray 14. Any serious or unstable concurrent disease, psychiatric disorder, or any significant condition that, in the opinion of the investigator, could confound the results of the study or could interfere with the participant's participation or compliance with the study 15. A recent (within 1 year of the screening visit) clinically significant history of drug or alcohol abuse, or dependence that, in the opinion of the investigator could interfere with the participant's participation or compliance with the study 16. Inability to read and understand English 17. Any medical condition that in the opinion of the investigator would interfere with the treatment 18. Any participant who is unfit to undergo surgery under general anesthesia 19. Current participation in another clinical trial at the time of the screening visit. 20. Participant is unable to undergo an awake procedure 21. Diagnosis or Aspirin Exacerbated Respiratory Disease (AERD)
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What it tests

  • Endoscopic polypectomy in clinic (EPIC)
  • Endoscopic Sinus Surgery (ESS)
  • General Anesthesia
  • Local and topical anesthesia
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Where

4 sites
Vancouver General Hospital
Vancouver, Canada
St. Joseph's Hospital London
London, Canada
Ottawa Hospital Research Institute
Ottawa, Canada
McGill University Health Center
Montreal, Canada
๐Ÿค Taking part is your choice, and you can leave at any time. Only the trial team can confirm you are eligible โ€” always decide together with your own doctor.
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