We devised a new combined therapy of CO2 LASER surgery and low-dose macrolide chemotherapy for chronic sinusitis. The effectiveness of this therapy was investigated in patients with chronic sinusitis and bilateral nasal polyps. Sixteen adult patients were first treated with 150 mg of roxithromycin (RXM) per day for more than 3 months, and if nasal symptoms failed to improve further, LASER surgery was performed. Under local anesthesia, nasal polyps were resected and vaporized with 6-8 W CO2LASER

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... focused on the morbid mucous membrane of the middle meatus and/or the middle turbinate. The patients rated the severity of nasal symptoms before and after therapy according to a 4-point scale (0: none; 1: slight; 2: moderate; 3: severe). Nasal symptoms were 1) obstruction, 2) amount of discharge, 3) sense of smell. Nasal obstruction and amount of nasal discharge were relieved in all patients, and in 82% of the patients the sense of smell improved. The degree of opacification of the maxillary and the ethmoid sinuses on X-ray films improved in 71% and 64%, respectively. There were no major complications. We think that we should choose this therapy for chronic sinusitis before performing Caldwell-Luc operation or endoscopic sinus surgery.