Quality of Life and Impact of Endoscopic Sinus Surgery in Adult Patients With Cystic Fibrosis

2019 ◽  
Vol 33 (4) ◽  
pp. 413-419 ◽  
Author(s):  
Maria S. Lazio ◽  
Paolo Luparello ◽  
Giuditta Mannelli ◽  
Giovanni P. Santoro ◽  
Silvia Bresci ◽  
...  

Background Cystic fibrosis (CF) is the most common autosomal recessive disease in Caucasian population. Due to its pathological mechanism, chronic rhino sinusitis (CRS) associated or not with nasal polyposis usually occurs in adults and affects close to one-half of all CF patients. The goal of our work was to evaluate the impact of endoscopic sinus surgery (ESS) in the quality of life (QoL) of the CF patients and demonstrate an improvement of the functional outcomes in the patients undergoing the surgical procedure rather than in the not treated ones. Methodology: We studied 54 adult patients affected by CF. Lund–Kennedy, Lund–Mackay scores, and Sino-Nasal Outcome Test-22 (SNOT-22) were analyzed. Results Twenty-two (40.7%) of the 54 CF patients underwent ESS. This group presented more likely complaints consistent with CRS. Lund–Kennedy and Lund–Mackay scores appeared higher in the ESS group: 10 (range of 6–12) and 16 (range of 12–20), respectively. SNOT-22 showed median values for non-ESS and ESS group of 17.5 (range of 3–68) and 44 (range of 10–73), respectively. Conclusions ESS represents the best option to improve clinical QoL of CF patients who do not response to conventional medical therapy.

Author(s):  
Amal P. Jose ◽  
Shibu George

<p class="abstract"><strong>Background:</strong> Chronic rhino sinusitis (CRS) is a common health problem affecting around 5-12% of the general population in a year. Treatment of CRS consist of medical and surgical management. Surgical management is considered when patient is not responding to maximal medical treatment or in case of complication. Sino nasal outcome test 22 (SNOT- 22) is considered as the most appropriate instrument in the evaluation of HRQOL impairment in CRS patients. This study evaluated general health related quality of life (QOL) domains of SNOT- 22 changes following endoscopic sinus surgery.</p><p class="abstract"><strong>Methods:</strong> This study was conducted in 53 subjects who underwent endoscopic sinus surgery for chronic rhino sinusitis in Department of otorhinolaryngology, Government Medical College, Kottayam over a period of one year. Detailed history including SNOT-22 questionnaire enquired. Clinical, radiological and endoscopic examinations were performed. This patient followed up after 1 week, 1month and 3 months. SNOT-22 scores were recorded at each visit; data compiled and analysed with help of SPSS.</p><p class="abstract"><strong>Results:</strong> The baseline SNOT-22 score for study population was 37.51. General health related quality of life domains was assessed separately. The score for psychological dysfunction and sleep dysfunction decreased from 10.72, 6.00 to 1.58 and 1.02 respectively at the end of 3 months.</p><p class="abstract"><strong>Conclusions: </strong>Chronic rhinosinusitis patients reported significant improvement in psychosocial dysfunction and sleep related symptoms after endoscopic sinus surgery. Chronic rhino sinusitis patient with anxiety and depressive disorders need special attention to improve health related quality of life (HRQOL).</p>


2009 ◽  
Vol 141 (3) ◽  
pp. 358-363 ◽  
Author(s):  
Ayesha N. Khalid ◽  
Jess Mace ◽  
Timothy L. Smith

OBJECTIVES: Adults with cystic fibrosis (CF) represent a challenging subset of patients with chronic rhinosinusitis (CRS). While data suggest that endoscopic sinus surgery (ESS) may benefit pediatric CF patients, there remains a paucity of data regarding the impact of endoscopic sinus surgery on adult CF patients with CRS. Our purpose was to evaluate objective and quality-of-life measures in adult CF patients with CRS following ESS. STUDY DESIGN: Nested case-control study. SETTING: Tertiary care center. METHODS: Twenty patients with CF were evaluated and matched to 20 controls without concomitant CF. Preoperative CT and preoperative/postoperative endoscopic findings were recorded as objective measures. Changes in two disease-specific quality-of-life (QoL) instruments were also evaluated both preoperatively and postoperatively. RESULTS: Mean postoperative follow-up was similar for cases and controls (13.1 ± 7.9 months vs 14.0 ± 6.0 months, respectively). Preoperative CT scores (16.9 ± 4.5 vs 10.9 ± 5.9, P = 0.001) and endoscopy scores (9.3 ± 5.8 vs 5.7 ± 4.6, P = 0.049) were significantly worse in CF patients. Postoperative endoscopy scores were significantly worse for CRS patients with CF ( P = 0.001), although the degree of improvement on endoscopy within each group was no different ( P = 0.071). Additionally, both groups experienced similar improvement in QoL after ESS (all P ≥ 0.134). CONCLUSIONS: While baseline measures of disease severity are worse in the CF population, our data support objective and QoL improvements for adult patients with comorbid CF comparable to patients without CF.


2019 ◽  
Vol 128 (12) ◽  
pp. 1129-1133
Author(s):  
Danny B. Jandali ◽  
Ashwin Ganti ◽  
Inna A. Husain ◽  
Pete S. Batra ◽  
Bobby A. Tajudeen

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.


2021 ◽  
pp. 000348942110456
Author(s):  
Stephen Leong ◽  
Rahul K. Sharma ◽  
Chetan Safi ◽  
Emily DiMango ◽  
Claire Keating ◽  
...  

Objectives: Appropriate management of chronic rhinosinusitis (CRS) among patients with cystic fibrosis (CF) is important in improving quality of life. Otolaryngologists play a critical role in reducing CRS symptom burden. This study seeks to evaluate the role of patient-reported quality-of-life measures in guiding interventions for CF-related sinus disease. Methods: We performed a prospective, cross-sectional study of 105 patients presenting to a CF-accredited clinic between July and September 2018. Demographic data and sinus surgery history were collected, in addition to Sino-Nasal Outcome Test (SNOT-22) and Questionnaire of Olfactory Disorders (QOD-NS) scores. Statistical analysis was conducted using correlation and non-parametric Mann-Whitney U tests. Results: Baseline well-care visits accounted for 71.4% of all clinical evaluations. Prior otolaryngology intervention was noted in 69 (66%) patients, where the majority of these patients (63/69; 91%) underwent endoscopic sinus surgery (ESS). Patients with a history of otolaryngology intervention had an average SNOT-22 score of 33.2 (SD = 20.6) compared to 24.9 (SD = 18.5) for patients without prior intervention ( P = .048). The average QOD-NS score was 5.5 (SD = 6.4) among patients referred to otolaryngologists and 3.1 (SD = 5.7) for non-referred patients ( P = .012). SNOT-22 and QOD-NS scores were modestly correlated ( R of .43). Conclusion: CF patients with symptoms resulting in worse quality-of-life assessments were more likely to have established coordinated care with an otolaryngologist. Further validation of the utility of SNOT-22 and QOD-NS questionnaires as care coordination metrics is necessary in the CF population.


2016 ◽  
Vol 274 (4) ◽  
pp. 1873-1882 ◽  
Author(s):  
Suzie Hyeona Kang ◽  
Camila Degen Meotti ◽  
Karine Bombardelli ◽  
Otávio Bejzman Piltcher ◽  
Paulo de Tarso Roth Dalcin

Author(s):  
Raies Ahmad Begh ◽  
Aditiya Saraf ◽  
Kamal Kishore ◽  
Parmod Kalsotra

<p class="abstract"><strong>Background:</strong> This paper aims to assess improvement in quality of life (QOL) after functional endoscopic sinus surgery through questionnaire sino-nasal outcome test (SNOT)-22.</p><p class="abstract"><strong>Methods:</strong> The present study was conducted on 50 patients in Department of ENT and HNS, SMGS Hospital, GMC Jammu during a time period of July 2017 to September 2019. All the patients with age ≥18 years who failed to respond to medical therapy (3 months) and underwent functional endoscopic sinus surgery (FESS) were included in the study. SNOT-22 questionnaire was used to assess the improvement.  </p><p class="abstract"><strong>Results:</strong> In our study, preoperative SNOT scores were higher (54±8.05) but after FESS they reduced significantly at 1st (16.47±5.51), 3rd (13.86±4.19), 6th months (12.9±8.05) post operatively. Chronic rhinosinusitis (CRS) with nasal polyposis group had greater mean difference of SNOT-22 scores (43.93) between preoperative period and 3 months postoperative period than patients grouped as CRS without nasal polyposis (41.47).</p><p class="abstract"><strong>Conclusions:</strong> We concluded that FESS is the best surgical intervention for chronic rhinosinusitis. It significantly improves the quality of life of patients of chronic rhinosinusitis.</p>


Sign in / Sign up

Export Citation Format

Share Document