Researchers conducted this study to compare the rate of surgical interventions for CRSwNP and CRSsNP.

Cases identified by CPT codes were extracted from State Ambulatory Surgery Databases for California, Florida, Maryland, and New York. Patient demographics, the extent of surgery, mean charges, and OR time were compared.

A total of 97,228 ESS cases were performed in the four states; 29.3% of surgeries were for patients with CRSwNP, 66.0% of patients with CRSsNP, and 4.8% for other indications. The proportion of ESS for CRSwNP varied across states, with California having the highest percentage and Maryland having the lowest. Patients with Medicaid and Medicare had higher surgery rates for CRSwNP compared with patients with private insurance. Surgeons who performed a higher volume of sinus surgery than lower-volume surgeons performed a lower percentage of surgery for CRSwNP. ESS cases for CRSwNP were more extensive, used image guidance more frequently, and were less likely to include a balloon procedure. Patients with CRSwNP had longer OR times but no difference in charges compared with patients with CRSsNP who underwent a similar extent of surgery.

The study concluded that almost 30% of ESS were performed for CRSwNP, and these cases were, on average, more extensive, used more OR time, and more often used image guidance than surgeries for CRSsNP. The surgery rate for CRSwNP varied based on geography, payer, and surgical volume, which indicated that patient selection impacted surgical management.