Indications and Outcomes for Patients With Limited Symptoms Undergoing Endoscopic Sinus Surgery

2020 ◽  
Vol 34 (4) ◽  
pp. 502-507
Author(s):  
Arifeen S. Rahman ◽  
Peter H. Hwang ◽  
Rahul Alapati ◽  
Yan Lin ◽  
Jayakar V. Nayak ◽  
...  
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Elective Surgery ◽  
Sinus Surgery ◽  
Point Reduction ◽  
Disease Characteristics ◽  
Clinical Presentations ◽  
Life Improvement ◽  
Sinonasal Outcome Test ◽  
Snot 22

Background Previous research have suggested that chronic rhinosinusitis (CRS) patients with lower symptomatic scores, demonstrated by a 22-item Sinonasal Outcome Test (SNOT-22) score <20, may not achieve meaningful quality of life improvement following endoscopic sinus surgery (ESS). However, indications for ESS are continuing to be defined and many low SNOT-22 scoring patients still undergo elective surgery for CRS and other benign sinonasal pathologies. The outcomes for these patients have not been previously studied. Objectives We sought to evaluate surgical indications and outcomes for those patients with limited symptoms undergoing ESS. Methods We screened 2829 ESS procedures from 2010–2018 to identify patients with a preoperative SNOT-22 score <20. We reviewed disease characteristics, preoperative Lund–Mackay (LM) scores, and pre- and postoperative SNOT-22 scores in patients with at least 3 months’ follow-up. Results Of all surgical ESS patients screened, 114 had low preoperative SNOT-22 scores (4.0%). Indications for these surgeries included CRS (50.0%), odontogenic sinus disease (11.4%), mucocele (10.5%), recurrent acute sinusitis (7.0%), fungal ball (5.3%), and silent sinus syndrome (4.4%). Specifically, among CRS patients, 45.6% had pulmonary comorbidities and/or systemic immunodeficiencies. Moreover, 100% of CRS patients with nasal polyps and 73.1% of CRS without polyps had LM scores >5. Patients with preoperative SNOT-22 scores between 15 and 19 achieved an average 6.5 point reduction ( P < .001) postoperatively, whereas those with scores between 10 and 14 had a 5.4 point reduction ( P < .001), and preoperative scores <9 resulted in no significant decrease in postoperative symptom scores ( P = .98). Overall, there was a 3.3 point SNOT-22 reduction among all patients at 3 months postoperatively ( P < .001). Conclusion Patients with limited sinonasal symptoms may benefit from surgical treatment despite asymptomatic clinical presentations. A case-by-case analysis of comorbidities or unique clinical features should inform surgical decision-making for patients with lower SNOT-22 scores.

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

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.

Effects of Depression on Quality of Life Improvement After Endoscopic Sinus Surgery

2008 ◽  
Vol 118 (3) ◽  
pp. 528-534 ◽  
Author(s):  
Jess Mace ◽  
Yvonne L. Michael ◽  
Nichole E. Carlson ◽  
Jamie R. Litvack ◽  
Timothy L. Smith
Keyword(s):  
Quality Of Life ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Life Improvement

scholarly journals Quality-of-life Improvement after Endoscopic Sinus Surgery in Patients with Obstructive Sleep Apnea

2017 ◽  
Vol 8 (1) ◽  
pp. ar.2017.8.0195 ◽  
Author(s):  
Bobby A. Tajudeen ◽  
Steven G. Brooks ◽  
Carol H. Yan ◽  
Edward C. Kuan ◽  
Joseph S. Schwartz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Obstructive Sleep ◽  
Life Improvement

scholarly journals Quality of life after functional endoscopic sinus surgery

2020 ◽  
Vol 6 (6) ◽  
pp. 1049
Author(s):  
Raies Ahmad Begh ◽  
Aditiya Saraf ◽  
Kamal Kishore ◽  
Parmod Kalsotra
Keyword(s):  
Quality Of Life ◽  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyposis ◽  
Surgical Intervention ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Time Period ◽  
Snot 22

<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>

scholarly journals Quality of life after endoscopic sinus surgery or balloon sinuplasty: a randomized clinical study

2014 ◽  
Vol 52 (4) ◽  
pp. 300-305
Author(s):  
A.J. Bizaki ◽  
R. Taulu ◽  
J. Numminen ◽  
M. Rautiainen
Keyword(s):  
Quality Of Life ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Balloon Sinuplasty ◽  
Randomized Clinical Study ◽  
Material Cost ◽  
Computer Tomography Scan ◽  
Significant Difference ◽  
Snot 22

Objectives: To conduct the first prospective randomized controlled trial that evaluates and compares the clinical outcome and impact of ballonsinuplasty and endoscopic sinus surgery (ESS) on the quality of life of patients suffering from chronic or recurrent rhinosinusitis (CRS) of the maxillary sinus. Methods: Adult patients with symptomatic chronic or recurrent rhinosinusitis without severe findings in the sinuses, as documented in the sinus’ Computer Tomography scan and clinical exam, were randomized in 2 groups: ESS and Balloon Sinuplasty.The main variable in our study is the Sinonasal Outcome Test-22 (SNOT 22) and its parameters. These parameters were analysed preoperatively and at 3 months, postoperatively. Results: There was a subjective improvement in symptoms after surgery. We also noticed an objective improvement in the quality of life of our patients seen as a decrease in the total SNOT 22 score. Both balloon sinuplasty and ESS significantly improved almost all the parameters of SNOT22, with no significant difference being found between these two groups. Conclusion: Both balloon sinuplasty and endoscopic sinus surgery improved the quality of life of patients with mild chronic or recurrent rhinosinusitis. However, the remarkably higher material cost of balloon sinuplasty compared to ESS sets limits on its broad use. There is an obvious need for further study to find out if, as an office procedure, balloon sinuplasty could deliver cost-savings high enough to cover the higher material cost of balloon sinuplasty. Our study was, however, too small to enable firm conclusions to be drawn.

Follow-Up Adherence Is Associated with Outcomes After Endoscopic Sinus Surgery

2020 ◽  
Vol 129 (7) ◽  
pp. 707-714
Author(s):  
Sarek A. Shen ◽  
Aria Jafari ◽  
Jesse R. Qualliotine ◽  
Adam S. DeConde
Keyword(s):  
Postoperative Period ◽  
Endoscopic Sinus Surgery ◽  
Nasal Symptom ◽  
Sinus Surgery ◽  
Psychological Dysfunction ◽  
Clinical Adherence ◽  
Sinonasal Outcome Test ◽  
The Impact ◽  
Snot 22

Background: Clinical follow-up after endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS) allows for assessment of the sinonasal cavity, debridement, and tailoring of medical therapies. Frequency and timing of postoperative clinical visits is debated, but the impact of adherence on disease-specific outcomes is not well understood. In this longitudinal study, we assessed the association between follow-up adherence and quality of life (QOL) outcomes in the 12 months after ESS. Methods: A retrospective review of patients undergoing ambulatory ESS for CRS between 11/2016 and 1/2018 was performed. We assessed sociodemographic characteristics, radiographic severity, and QOL utilizing the 22-item sinonasal outcome test (SNOT-22). Patients were categorized as “non-adherent,” “moderately-adherent,” and “fully-adherent” to a 1-, 3- and 5-week postoperative visit schedule. Results: A total of 166 patients met the inclusion criteria. Of these, 55 (33.1%) were fully-adherent, 105 (63.2%) were moderately-adherent, and 6 (3.6%) were non-adherent within the 6 weeks following ESS. In the immediate postoperative period, fully-adherent patients demonstrated worse QOL (SNOT-22: 31.2 ± 23.1 vs 27.5 ± 17.6, P = .047). This cohort also had greater psychological dysfunction at baseline and 12-months ( P < .05) after ESS. Extra-nasal symptom scores increased at a lower rate in the fully-adherent cohort (0.12 vs 1.29 points per 6 months, P = .038), as did ear/facial symptoms (1.17 vs 3.05 points per 6 months, P = .044). Conclusion: Despite worse symptom severity in the immediate postoperative period, patients who are more adherent to the follow-up schedule demonstrated slower return of symptoms in the extra-rhinological and ear-facial domains. These findings suggest that clinical adherence and management may impact the long-term evolution of ESS outcomes.

scholarly journals Quality of Life Outcomes in Frontal Sinus Surgery

2020 ◽  
Vol 9 (7) ◽  
pp. 2145
Author(s):  
Christos Georgalas ◽  
Marios Detsis ◽  
Ioannis Geramas ◽  
Dimitris Terzakis ◽  
Andreas Liodakis
Keyword(s):  
Quality Of Life ◽  
Endoscopic Sinus Surgery ◽  
Frontal Sinus ◽  
Sinus Surgery ◽  
Frontal Sinus Surgery ◽  
Patient Reported ◽  
The Mean ◽  
Snot 22 ◽  
Postoperative Quality

Introduction: Although significant experience has been gained in the technical nuances of endoscopic sinus surgery procedures, the patient-reported outcomes of frontal endoscopic sinus surgery procedures are still poorly understood. In this study we used the validated patient outcome measure Sino Nasal Outcome Test-22 (SNOT-22) to assess the preoperative and postoperative quality of life in patients undergoing extended endoscopic frontal sinus surgery (Draf type 2 and Draf type 3 procedures). Methods: Out of a total of 680 patients undergoing endoscopic sinus and skull base surgery and 186 patients undergoing frontal sinus surgery, 99 chronic rhinosinusitis patients with (CRSwNP) or without (CRSnNP) nasal polyps undergoing Draf 2 or Draf 3 were assessed. Results: The mean preoperative SNOT-22 was 45.6 points for patients undergoing Draf 2 and 59 for patients undergoing Draf 3, while the mean radiological Lund–Mackay Score was 14.3 and 14.5, respectively. Mean SNOT 22 improvement was 22.9 points for Draf 2 and 37 points for Draf 3 respectively and remained significant in all time intervals, including at 4 years after surgery. With the exception of loss of smell/taste, all symptoms improved by a far bigger extent in Draf 3 group, despite the considerably worse starting point. Effect size (Cohen / Standard Deviations) of Draf 3 was greatest in the following symptoms: “being frustrated/restless/irritable” (1.63), “nasal blockage” (1.43), “reduced concentration” (1.35), “fatigue” (1.29) “runny nose” (1.26) and “need to blow nose” (1.17). Frontal sinus (neo) ostium was patent (fully or partly) at last follow up in 98% of Draf 2 patients and in 88% of patients following Draf 3. Patients with non-patent frontal (neo-) ostium however had a mean postoperative SNOT 22 score of 43 compared to 20 of those with patent frontal sinus (neo-) ostium, although the difference was not statistically significant. Conclusion: Patients undergoing Draf 3 have a greater burden of disease, including both nasal and emotional/general symptoms compared to Draf 2 patients; surgery results in improvement in both groups, although Draf 3 patients have the greatest benefit, especially in emotional / general symptons. In this way both groups achieve similar postoperative quality of life, despite the different starting points.

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 ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cystic Fibrosis ◽  
Endoscopic Sinus Surgery ◽  
Adult Patients ◽  
Sinus Surgery ◽  
Conventional Medical Therapy ◽  
Chronic Rhino Sinusitis ◽  
The Impact ◽  
Snot 22

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.

scholarly journals Effect of endoscopic sinus surgery on general health related quality of life domains in chronic rhino sinusitis patients

2020 ◽  
Vol 6 (9) ◽  
pp. 1672
Author(s):  
Amal P. Jose ◽  
Shibu George
Keyword(s):  
Quality Of Life ◽  
Endoscopic Sinus Surgery ◽  
General Health ◽  
Sinus Surgery ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Chronic Rhino Sinusitis ◽  
Snot 22

<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>

Sign in / Sign up

Export Citation Format

Share Document