scholarly journals Impact of Pharmacotherapy to decrease Interleukin-6 in patients with chronic rhinosinusitis without nasal polyp

2020 ◽  
Vol 50 (1) ◽  
pp. 30
Author(s):  
Lina Marlina ◽  
Sinta Sari Ratunanda ◽  
Teti Madiadipoera
Keyword(s):  
Quality Of Life ◽  
Chronic Rhinosinusitis ◽  
Visual Analog Scale ◽  
Interleukin 6 ◽  
Analog Scale ◽  
Prick Test ◽  
Significant Difference ◽  
Sinonasal Outcome Test ◽  
Snot 22

Background: Chronic rhinosinusitis (CRS) is an inflammation of the nasal and paranasal sinuses mucosa, ongoing for more than 12 weeks. Even now it still creates socioeconomic problem in both developed and developing countries. Pharmacotherapy administration is essential for decreasing the severity of symptom, improving quality of life, and decreasing interleukin (IL)-6 level. Objective: To find out the effect of pharmacotherapy on severity of the symptom, quality of life, and IL-6 level. Method: Randomized clinical trial with pre and posttest design, on 20 CRS without polyp patients, divided into two groups based on skin prick test results. Both groups were equally treated with nasal irrigation, nasal corticosteroid, and antibiotic amoxicillin clavulanate for 14 days. All subjects were assessed for Visual Analog Scale (VAS) score, nasoendoscopy (NE) score, Sinonasal Outcome test (SNOT)-22, and IL-6 level. Statistical analysis was performed with Mann Whitney and Wilcoxon methods. Result: There were significant differences in total analysis results on VAS scores, NE scores, SNOT-22, and IL-6 levels in both groups, with values p<0.05. There was improvement in all variables after pharmacotherapy, but there was no significant difference between the case and control groups, with values p>0.05. Conclusion: Pharmacotherapy in both groups resulte’ in reduced severity of symptoms, improved quality of lives, and decreased IL-6 levels.Keywords: Interleukin-6, pharmacotherapy, chronic rhinosinusitis without polyp, quality of life ABSTRAK Latar belakang: Rinosinusitis kronik (RSK) merupakan inflamasi pada mukosa hidung dan sinus paranasal, yang berlangsung selama lebih dari 12 minggu. Hingga saat ini masih memengaruhi sosioekonomi di negara maju maupun negara berkembang. Pemberian farmakoterapi sangat penting untuk memperbaiki derajat gejala, meningkatkan kualitas hidup, dan menurunkan kadar interleukin (IL)-6. Tujuan: Mengetahui pengaruh pemberian farmakoterapi terhadap perbaikan derajat gejala, peningkatan kualitas hidup, dan penurunan kadar IL-6. Metode: Penelitian kuasi eksperimental, label terbuka pra dan pascaterapi, pada 20 penderita RSK tanpa polip, dibagi dua kelompok berdasarkan hasil uji tusuk kulit. Perlakuan pada kedua kelompok sama, diberikan irigasi hidung, kortikosteroid intranasal, dan antibiotik amoksisilin klavulanat selama 14 hari. Penelitian dilakukan dengan menilai skor Visual Analog Scale (VAS) gejala hidung, skor nasoendoskopi (NE), Sinonasal Outcome test (SNOT)-22, dan kadar IL-6. Analisis statistik menggunakan metode Mann Whitney dan Wilcoxon. Hasil: Didapati perbedaan bermakna pada hasil analisis total pada skor VAS gejala hidung, skor NE, SNOT-22, dan kadar IL-6 pada kedua kelompok dengan nilai p<0,05. Didapati perbaikan pada semua variabel setelah 14 hari pemberian medikamentosa maksimal, namun tidak terdapat perbedaan bermakna antara kedua kelompok dengan nilai p>0,05. Kesimpulan: Pemberian farmakoterapi pada kedua kelompok memberikan hasil berupa perbaikan derajat gejala, peningkatan kualitas hidup, dan penurunan kadar IL-6.

scholarly journals The 22-Item Sinonasal Outcome Test as a Tool for the Assessment of Quality of Life and Symptom Control in Allergic Rhinitis

2019 ◽  
Vol 34 (2) ◽  
pp. 209-216
Author(s):  
Qasim Husain ◽  
Lloyd Hoehle ◽  
Katie Phillips ◽  
David S. Caradonna ◽  
Stacey T. Gray ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Visual Analog Scale ◽  
Symptom Control ◽  
Patient Reported Outcome ◽  
Analog Scale ◽  
Patient Reported ◽  
Sinonasal Outcome Test ◽  
Snot 22

Background The 22-item Sinonasal Outcome Test (SNOT-22) is a validated patient-reported outcome measure for chronic rhinosinusitis and in many circumstances is used in rhinology/otolaryngology clinics to assess sinonasal symptoms in general when a formal diagnosis is not established, although with little support for such usage. Objective To assess the utility of the SNOT-22 as a reflection of quality of life (QOL) and symptom control for patients with allergic rhinitis (AR). Methods Retrospective review of 353 patients with persistent AR. Each patient completed a SNOT-22, 5-item EuroQol general health-related QOL (EQ-5D) questionnaire (from which the visual analog scale [VAS] was used), and Rhinitis Control Assessment Test (RCAT). In addition, 95 patients also completed these questionnaires 1 to 12 months later. Results The SNOT-22 was negatively correlated with the EuroQol 5-dimensional visual analog scale (EQ-5D VAS; r = −.45, 95% confidence interval [CI]: −0.53 to −0.36, P < .001) and RCAT ( r = −.62, 95% CI: −0.68 to −0.55, P < .001), with excellent internal consistency. The SNOT-22 demonstrated responsiveness, with mean change of −5.8 (95% CI: −8.9 to −2.6, P < .001) from pre- to posttreatment. The change in SNOT-22 over the treatment period was correlated with change in EQ-5D VAS ( r = −.28, 95% CI: −0.46 to −0.07, P = .008) and RCAT ( r = −.56, 95% CI: −0.69 to −0.41, P < .001). The minimal clinically important difference was calculated to be between 6 and 11. Conclusion The SNOT-22 has utility to assess QOL and symptom control in AR, and it is both reliable and responsive in its application to patients with AR. The SNOT-22 may therefore be a convenient and versatile tool in the clinical assessment of patients with AR.

scholarly journals Evaluation of the Effect of Conventional Rhinoplasty with Autospreader Flap and Let-Down Technique on Nasal Functions

2021 ◽  
Author(s):  
Burak Mustafa Taş ◽  
Burak Erden
Keyword(s):  
Quality Of Life ◽  
Significant Difference ◽  
Quality Of Life Scale ◽  
Life Scale ◽  
Sinonasal Outcome Test ◽  
Group 2 ◽  
And Gender ◽  
Snot 22 ◽  
Group 1

AbstractLet-down technique, in which high septal strip resection is performed, and conventional rhinoplasty using autospreader flaps were compared regarding nasal functions with Nasal Obstruction Symptom Evaluation (NOSE) and Sinonasal Outcome Test-22 (SNOT-22) quality-of-life scale questionnaires. A total of 54 patients who were included in the study were divided into two groups: group 1 (autospreader group; n = 27) and group 2 (let-down group; n = 27). Open technical septorhinoplasty operation using an autospreader flap was performed in group 1. Let-down rhinoplasty was applied in group 2. NOSE and SNOT-22 scales were filled for the groups in the preoperative and postoperative periods and were compared. Postoperative values were found to be significantly lower than preoperative values in both groups (p < 0.001). When the groups were compared in between, no significant difference was seen according to the scales (p > 0.05). There was also no significant difference between the groups regarding age and gender. Although there was no significant difference between the two techniques, both NOSE and SNOT-22 quality-of-life scales have shown improvement both in conventional rhinoplasty with autospreader flap and let-down technique.

scholarly journals Validity and Reliability of the French Short Version of the Questionnaire of Olfactory Disorders-Negative Statements (sQOD-NS)

2021 ◽  
pp. 014556132110320
Author(s):  
Céline Leclercq ◽  
Carlos M. Chiesa-Estomba ◽  
Mihaela Horoi ◽  
Serge D. Le Bon ◽  
Stephane Hans ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Visual Analog Scale ◽  
Internal Consistency ◽  
External Validity ◽  
Short Version ◽  
Analog Scale ◽  
Negative Statements ◽  
The Impact ◽  
Snot 22

Objective: To develop a French Short Version of the Questionnaire of Olfactory Disorders-Negative Statements (Fr-sQOD) to assess the quality of life impairments of patients with olfactory dysfunction (OD). Methods: Patients with OD and controls were enrolled from 2 academic centers. Individuals completed the Fr-sQOD, an OD visual analog scale severity, and the French version of the sinonasal outcome tool-22 (SNOT-22). Cronbach α was used to measure the internal consistency of Fr-sQOD. The reliability and the external validity of Fr-sQOD were assessed through a test–retest approach and by correlating Fr-sQOD with SNOT-22 scores, respectively. The external validity was assessed by correlation analysis between Fr-sQOD and the result of an assessment of the severity of OD on a visual analog scale. Results: Eighty patients completed the evaluations. The internal consistency was adequate (Cronbach α .96), and the test–retest reliability was high in the entire cohort (rs = 0.877, P < .001). The correlation between Fr-sQOD total scores and the severity of OD was moderate but significant (rs = −0.431; P = .001) supporting an acceptable external validity. Patients with OD had a significantly higher score of Fr-sQOD than healthy individuals ( P < .001), indicating a high internal validity. Conclusion: The Fr-sQOD is a reliable and valid self-administered tool in the evaluation of the impact of OD on quality of life of French-speaking patients.

scholarly journals Mucosal Eosinophilia and Neutrophilia Are Not Associated With QOL or Olfactory Function in Chronic Rhinosinusitis

2021 ◽  
pp. 194589242098743
Author(s):  
Nyssa F. Farrell ◽  
Jess C. Mace ◽  
David A. Sauer ◽  
Andrew J. Thomas ◽  
Mathew Geltzeiler ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyposis ◽  
Cross Sectional Study ◽  
Olfactory Function ◽  
Sinus Surgery ◽  
Small Subset ◽  
Cross Sectional ◽  
Snot 22

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.

Clinical Traits Characterizing an Exacerbation-Prone Phenotype in Chronic Rhinosinusitis

2019 ◽  
Vol 161 (5) ◽  
pp. 890-896 ◽  
Author(s):  
Katie M. Phillips ◽  
Eric Barbarite ◽  
Lloyd P. Hoehle ◽  
David S. Caradonna ◽  
Stacey T. Gray ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Disease Burden ◽  
Tertiary Care ◽  
Symptom Burden ◽  
Cross Sectional ◽  
Patient Reported ◽  
Oral Corticosteroids ◽  
Sinonasal Outcome Test ◽  
Snot 22

Objective Acute exacerbation of chronic rhinosinusitis (AECRS) is associated with significant quality-of-life decreases. We sought to determine characteristics associated with an exacerbation-prone phenotype in chronic rhinosinusitis (CRS). Study Design Cross-sectional. Setting Tertiary care rhinology clinic. Subjects Patients with CRS (N = 209). Methods Patient-reported number of sinus infections, CRS-related antibiotics, and CRS-related oral corticosteroids taken in the last 12 months were used as metrics for AECRS frequency. Sinonasal symptom burden was assessed with the 22-item Sinonasal Outcome Test (SNOT-22). Ninety patients reporting 0 for all AECRS metrics were considered to have had no AECRS in the prior 12 months. A total of 119 patients reported >3 on at least 1 AECRS metric and were considered as having an exacerbation-prone phenotype. Characteristics associated with patients with an exacerbation-prone phenotype were identified with exploratory regression analysis. Results An exacerbation-prone phenotype was positively associated with comorbid asthma (adjusted odds ratio [ORadj] = 3.68, 95% CI: 1.42-9.50, P = .007) and SNOT-22 (ORadj = 1.06, 95% CI: 1.04-1.09, P < .001). Polyps were negatively associated (ORadj = 0.27, 95% CI: 0.11-0.68, P = .005) with an exacerbation-prone phenotype. SNOT-22 score ≥24 identified patients with an exacerbation-prone phenotype with a sensitivity of 93.3% and a specificity of 57.8%. Having either a SNOT-22 score ≥24 with a nasal subdomain score ≥12 or a SNOT-22 score ≥24 with an ear/facial discomfort subdomain score ≥3 provided >80% sensitivity and specificity for detecting patients prone to exacerbation. Conclusions In total, these results point to a CRS exacerbation-prone phenotype characterized by high sinonasal disease burden with comorbid asthma but interestingly without polyps.

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.

scholarly journals DISCORDANCE IN GOALS OF CARE BETWEEN PATIENTS WITH ADVANCED CANCER AND THEIR CAREGIVERS: DOES AGE PLAY A ROLE?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S54-S54
Author(s):  
Amy R Lipson ◽  
Sara Douglas
Keyword(s):  
Quality Of Life ◽  
Advanced Cancer ◽  
Visual Analog Scale ◽  
Treatment Decisions ◽  
Analog Scale ◽  
Goals Of Care ◽  
The Impact

Abstract Cancer is considered a family disease as the caregivers (CG’s) role extends beyond providing care as they can also help facilitate treatment decisions. While much has been reported in the literature about patient (PT) goals of care (GoC), little is known about discordance between PT and CG GoC and the impact of PT age. The variables of interest were PT and CG identified GoC using a 100-point visual analog scale (VAS) with anchors of quality of life (0) and survival (100). Discordance was defined as a &gt; 40 point difference on the VAS. The GoC data reported here were those obtained at enrollment and prior to subject’s death. A sample of 235 PTs and CGs of PTs diagnosed with advanced cancers were included in the study. Mean age for the PTs was 64.7 (SD=10.5, range =21-88) with 54% being &gt; 65. At enrollment, 28.7% of the PT-CG pairs of those PTs 65 years (X2 (1)=1.06, p=.304). At death, 61.8% (X2 (1)=31.04 &lt;.001, Φ=.49) with discord at enrollment had discord at death. For patients who were older, 66.7% who had discord at enrollment also had discord at death and for patients

Atopy and Quality of Life in Pediatric Chronic Rhinosinusitis

2019 ◽  
Vol 33 (5) ◽  
pp. 586-590 ◽  
Author(s):  
Anamika Anamika ◽  
Arunabha Chakravarti ◽  
Raj Kumar
Keyword(s):  
Quality Of Life ◽  
Skin Prick Test ◽  
Chronic Rhinosinusitis ◽  
Cross Sectional Study ◽  
Endoscopic Examination ◽  
Positive Skin Prick Test ◽  
Cross Sectional ◽  
Positive Skin ◽  
Prick Test

Background Atopy has been suggested in the development of chronic rhinosinusitis (CRS), as allergic rhinitis (AR) is common coexisting disease in pediatric and adult patients with CRS. The contribution of AR to CRS is less clear till date. Objectives The objectives of this study were to determine atopic profile of children with CRS and impact of atopic status on disease severity and quality of life. Methods One hundred ten patients, aged between 7 and 18 years of age, diagnosed with CRS based on history, detailed clinical examination including nasal endoscopic examination were included in this cross-sectional study. Scoring of CRS was done according to Lund Mackay Endoscopic Appearance Score. Patients underwent skin prick test against 65 common aeroallergens (1:10 w/v, 50% glycerinated) for evidence of atopy. SN-5 Sinus and Nasal Quality of Life Survey was used to assess the quality of life in the study subjects. Results Positive skin prick test to at least one of the common aeroallergens was present in 58 (52.7%) patients. Most common aeroallergen sensitivity was seen with insects in 48 (43.6%) patients. Patients of CRS with atopy had higher mean Lund Mackay endoscopic score and SN-5 score than nonatopic patients which was statistically significant. Conclusion In conclusion, we recommend that testing for aeroallergen sensitivity and assessment of quality of life should be included in the protocol for diagnosis and management of pediatric patients with CRS. Early diagnosis and treatment of allergy may halt the progression of CRS and also the development of asthma and other allergic multimorbid disorders.

scholarly journals Hyeonggaeyeongyo-Tang for Treatment of Allergic and Nonallergic Rhinitis: A Prospective, Nonrandomized, Pre-Post Study

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Min-Hee Kim ◽  
Jaewoong Son ◽  
Hae Jeong Nam ◽  
Seong-Gyu Ko ◽  
Inhwa Choi
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Life Questionnaire ◽  
Nonallergic Rhinitis ◽  
Prick Test ◽  
Chronic Rhinitis ◽  
Nasal Symptoms ◽  
Significant Difference

Hyeonggaeyeongyo-tang (HYT) is an ancient formula of oriental medicine traditionally used to treat rhinitis; however, clinical evidence has not yet been established. The aim of this study was to investigate the short-term and long-term efficacy and safety of HYT for chronic rhinitis. Adult subjects with chronic rhinitis symptoms were recruited. The subjects received HYT for 4 weeks and had follow-up period of 8 weeks. Any medicines used to treat nasal symptoms were not permitted during the study. The skin prick test was performed to distinguish the subjects with allergic rhinitis from those with nonallergic rhinitis. After treatment, the total nasal symptoms score and the Rhinoconjunctivitis Quality of Life Questionnaire score significantly improved in the whole subject group, in the allergic rhinitis group, and in the nonallergic rhinitis group, with no adverse events. This improvement lasted during a follow-up period of 8 weeks. Total IgE and eosinophil levels showed no significant difference after treatment in the allergic rhinitis group. HYT improved nasal symptoms and quality of life in patients with allergic rhinitis and nonallergic rhinitis. This is the first clinical study to evaluate the use of HYT to treat patients with rhinitis. This trial has been registered with the ClinicalTrials.gov IdentifierNCT02477293.

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