Improvement of quality of life after septoplasties and endonasal sinus surgery

Background Chronic rhinosinusitis (CRS) is often differentiated by histopathologic phenotypes (eosinophilic versus neutrophilic), which may impact disease severity measures and outcomes. As such, it has been suggested that counts of cellular elements be included as part of a standard pathological report following endoscopic sinus surgery (ESS). Objectives This cross-sectional study evaluated associations of mucosal eosinophilia and neutrophilia with measures of quality-of-life (QoL) and olfactory function. Methods Patients with medically refractory CRS completed the SNOT-22 survey and Brief Smell Identification Test (BSIT) at enrollment. In addition, baseline Lund-Mackay computed tomography (CT) and Lund-Kennedy endoscopy scores were collected. Ethmoid mucosa was biopsied during ESS and reviewed using microscopy to quantify densest infiltrate of eosinophils or neutrophils per high-powered-field (HPF). Eosinophilic CRS (eCRS) and neutrophilic CRS (nCRS), both with and without nasal polyposis (NP), were compared across SNOT-22 and BSIT scores. Results 77/168 patients demonstrated mucosal eosinophilia (eCRS) while a total of 42/168 patients demonstrated mucosal neutrophilia (nCRS). After adjusting for polyp status, 35/168 had eCRSsNP, 42/168 eCRSwNP, 75/168 non-eCRSsNP, 16/168 non-eCRSwNP. Additionally, 22/161 were noted to have nCRSsNP, 20/161 nCRSwNP, 84/161 non-nCRSwNP, and 35/161 non-nCRSsNP. A small subset of patients demonstrated both eosinophilia and neutrophilia: 14 CRSwNP and 7 CRSsNP. When evaluating average Lund-Mackay Scores (LMS), significant differences existed between non-eCRSsNP and eCRSsNP (p = 0.006). However, after controlling for nasal polyps, eosinophilia did not significantly associate with differences in the Lund-Kennedy Score. Neutrophilia did not significantly associate with any changes in LMS or LKS after controlling for NP. Eosinophilic and neutrophilic histopathologic subtypes did not significantly associate with differences in baseline SNOT-22 or BSIT measures after controlling for NP. Conclusion Neither the presence of mucosal eosinophilia nor mucosal neutrophilia demonstrated significant associations with SNOT-22 quality-of-life or BSIT olfactory function scores when controlling for comorbid nasal polyposis.

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Sinus surgery can improve quality of life, lung infections, and lung function in patients with primary ciliary dyskinesia

International Forum of Allergy & Rhinology ◽

10.1002/alr.21873 ◽

2016 ◽

Vol 7 (3) ◽

pp. 240-247 ◽

Cited By ~ 22

Author(s):

Mikkel Christian Alanin ◽

Kasper Aanaes ◽

Niels Høiby ◽

Tania Pressler ◽

Marianne Skov ◽

...

Keyword(s):

Quality Of Life ◽

Lung Function ◽

Primary Ciliary Dyskinesia ◽

Sinus Surgery ◽

Improve Quality ◽

Lung Infections ◽

Ciliary Dyskinesia

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Machine-Learning Points at Endoscopic, Quality of Life, and Olfactory Parameters as Outcome Criteria for Endoscopic Paranasal Sinus Surgery in Chronic Rhinosinusitis

Journal of Clinical Medicine ◽

10.3390/jcm10184245 ◽

2021 ◽

Vol 10 (18) ◽

pp. 4245

Author(s):

Jörn Lötsch ◽

Constantin A. Hintschich ◽

Petros Petridis ◽

Jürgen Pade ◽

Thomas Hummel

Keyword(s):

Quality Of Life ◽

Machine Learning ◽

Chronic Rhinosinusitis ◽

Paranasal Sinus ◽

Endoscopic Sinus Surgery ◽

Relevant Information ◽

Olfactory Function ◽

Sinus Surgery ◽

Paranasal Sinus Surgery

Chronic rhinosinusitis (CRS) is often treated by functional endoscopic paranasal sinus surgery, which improves endoscopic parameters and quality of life, while olfactory function was suggested as a further criterion of treatment success. In a prospective cohort study, 37 parameters from four categories were recorded from 60 men and 98 women before and four months after endoscopic sinus surgery, including endoscopic measures of nasal anatomy/pathology, assessments of olfactory function, quality of life, and socio-demographic or concomitant conditions. Parameters containing relevant information about changes associated with surgery were examined using unsupervised and supervised methods, including machine-learning techniques for feature selection. The analyzed cohort included 52 men and 38 women. Changes in the endoscopic Lildholdt score allowed separation of baseline from postoperative data with a cross-validated accuracy of 85%. Further relevant information included primary nasal symptoms from SNOT-20 assessments, and self-assessments of olfactory function. Overall improvement in these relevant parameters was observed in 95% of patients. A ranked list of criteria was developed as a proposal to assess the outcome of functional endoscopic sinus surgery in CRS patients with nasal polyposis. Three different facets were captured, including the Lildholdt score as an endoscopic measure and, in addition, disease-specific quality of life and subjectively perceived olfactory function.

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Comprehensive quality of life outcomes for pediatric patients undergoing endoscopic sinus surgery

Rhinology Journal ◽

10.4193/rhin14.028 ◽

2014 ◽

Vol 52 (4) ◽

pp. 327-333 ◽

Cited By ~ 9

Author(s):

R.J. Taylor ◽

J.D. Miller ◽

A.S. Rose ◽

A.F. Drake ◽

C.J. Zdanski ◽

...

Keyword(s):

Quality Of Life ◽

Endoscopic Sinus Surgery ◽

Pediatric Patients ◽

Sinus Surgery ◽

Life Outcomes ◽

Quality Of Life Outcomes

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IMPROVEMENT OF QUALITY OF LIFE AFTER ENDOSCOPIC SINUS SURGERY FOR CHRONIC RHINO-SINUSITIS

Journal of Sulaimani Medical College ◽

10.17656/jsmc.10064 ◽

2015 ◽

Vol 5 (1) ◽

pp. 27-32

Author(s):

Muaid Ismaiel Aziz ◽

Keyword(s):

Quality Of Life ◽

Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Chronic Rhino Sinusitis

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The Effects of Endoscopic Sinus Surgery on Voice Characteristics in Chronic Rhinosinusitis Patients

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489419861124 ◽

2019 ◽

Vol 128 (12) ◽

pp. 1129-1133

Author(s):

Danny B. Jandali ◽

Ashwin Ganti ◽

Inna A. Husain ◽

Pete S. Batra ◽

Bobby A. Tajudeen

Keyword(s):

Quality Of Life ◽

Chronic Rhinosinusitis ◽

Endoscopic Sinus Surgery ◽

Tertiary Care ◽

Voice Quality ◽

Upper Airway ◽

Sinus Surgery ◽

Perceptual Evaluation ◽

Snot 22

Objectives: Functional endoscopic sinus surgery (FESS) is a standard treatment modality for patients with chronic rhinosinusitis (CRS) who have failed appropriate medical therapy. However, FESS entails modification of the upper airway tract that may alter phonatory resonance and produce voice changes. The effects of FESS on postoperative voice characteristics in patients with CRS have yet to be quantitatively assessed. Methods: Patients with severe CRS who underwent FESS at a tertiary care referral center between May and October 2017 were prospectively enrolled. The Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) and the Voice Handicap Index (VHI) were used to quantitatively evaluate voice characteristics and quality of life, respectively. Preoperative and postoperative CAPE-V and VHI scores were compared with postoperative scores for each patient. Sino-Nasal Outcome Test (SNOT-22) scores were also obtained to assess changes in patient symptoms. Results: 18 CRS patients undergoing FESS were enrolled. The average preoperative Lund-Mackay score was 14, indicating baseline severe CRS. Postoperative assessments demonstrated a statistically significant decrease in CAPE-V (45-27, p = .005) and VHI (10-4.7, p < .001) scores. These correlated with a statistically significant decrease in SNOT-22 scores (42-13, p < .001). Conclusions: Patients with CRS experience a significant improvement in voice characteristics and vocal quality of life following FESS. Furthermore, this appears to correlate with a significant decrease in self-reported disease severity. These findings may augment the discussion of potential benefits of FESS to a new potential domain for voice quality.

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