Limitations
The study has several important limitations. Firstly, the retrospective
nature of the data introduces significant source of selections bias. All
the comparisons of outcomes between the treatment groups should be
interpreted cautiously. While we attempted to assess and compare a
number of possible sources of bias (time to surgery, size of collection
etc.) between the groups, it is possible that some important factors
were not accounted. Secondly, as it was a retrospective review, we were
unable to extract the clinicians’ reasoning behind choosing one
treatment strategy over another. Thirdly, small sample of patients
treated with conservative and neurosurgery only approaches, prevents
meaningful comparisons and risk type 2 error. The data on the individual
procedures was provided, however subgroup analysis stratified by the
type of sinus intervention was not feasible due to low patient numbers.
Finally, no patient reported outcomes were collected.