scholarly journals Comparison of Endoscopic Sinus Surgery and Continued Medical Treatment Therapy for Refractory Chronic Rhinosinusitis

2021 ◽  
Vol 15 (9) ◽  
pp. 2285-2288
Author(s):  
Sadaf Raffat ◽  
Mustafa . ◽  
Nighat Arif ◽  
Usman Aslam ◽  
M Mubarik Ali ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Medical Treatment ◽  
Chronic Rhinosinusitis ◽  
Medical Therapy ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Group A ◽  
Group B ◽  
Disease Specific

Aim: To compare endoscopic sinus surgery and continued medical treatment in refractory refractory chronic rhinosinusitis (CRS) patients regarding diseases specific quality of life measurement Study design: RCT (Randomized controlled trial) Place and duration of study: Study was conducted at ENT (Ear, nose and throat) department, Railway Hospital Rawalpindi. Study duration was one year (January 2018-Deecember 2018) Methods: A sample size of 22 patients was calculated using WHO calculator. Non probability consecutive sampling was used. A prior ethical approval and consent form was taken. Patients were randomly divided into two groups; Group A was given medical therapy while Group B comprised contain patients in whom medical therapy failed and had undergone endoscopic sinus surgery. Patients were followed for disease specific quality of life scores. Data was analyzed using SPSS version22. Chi-square and t test was applied. P value ≤ 0.05 was considered significant. Results: Total of 22 refractory CRS patients were included in study. There were 10(45.5%) males and 12(54.5%) females. Mean age of refractory CRS patients was 33.4 years±6.2SD. Group A (continued medical therapy) N=11, had significantly high SNOTT -22 scores 60.6±7.1SD as compared to endoscopic sinus surgery 21±3.9SD (p=0.000). Group B (endoscopic sinus surgery) had significantly low endoscopic scores 2.7±0.3SD as compared to group A (continued medical therapy) 7.14±0.53SD (p=0.000). Endoscopic sinus surgery group showed significant reduction in work days lost 17.4±4.9SD as compared to continued medical therapy (Group A) 30.1±2.5SD (p=0.000). Conclusion: Endoscopic sinus surgery is an effective treatment option as compared to continued medical therapy with improved quality of life in refractory CRS patients (with reduced baseline disease specific quality of life). Keywords: Refractory chronic rhinosinusitis, endoscopic sinus surgery, quality of life

Outcome of endoscopic sinus surgery for chronic rhinosinusitis patients: a Canadian experience

2010 ◽  
Vol 124 (10) ◽  
pp. 1095-1099 ◽  
Author(s):  
Y Al Badaai ◽  
M Samaha
Keyword(s):  
Quality Of Life ◽  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
General Health ◽  
Chronic Sinusitis ◽  
Short Form ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Disease Specific

AbstractObjectives:To determine the effect on patients' quality of life of functional endoscopic sinus surgery performed for chronic rhinosinusitis within a tertiary care centre in Montreal, Canada.Methods:A prospective cohort study was undertaken. Subjects were consecutive patients with a diagnosis of chronic rhinosinusitis who had failed medical treatment and were undergoing functional endoscopic sinus surgery. Questionnaires assessing general health outcomes (i.e. the second version of the Short Form 12 questionnaire) and disease-specific outcomes (i.e. the Chronic Sinusitis Survey) were completed pre-operatively and a minimum of three months post-operatively.Results:A total of 152 patients were enrolled over a seven-month period, of whom 120 completed the post-operative surveys. The most common co-morbidity was asthma (40 per cent). Of the 120 patients with completed questionnaires, 72 per cent reported clinical improvement, 12 per cent reported deterioration and 15 per cent remained unchanged. The average improvement in Chronic Sinusitis Survey score was 17 per cent.Conclusion:Patients with chronic rhinosinusitis achieved a significant improvement in disease-specific quality of life after functional endoscopic sinus surgery. There was no significant improvement in general health related quality of life, as measured using the Short Form 12 questionnaire.

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

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.

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 Endoscopic sinus surgery in adult patients with Chronic Rhinosinusitis with nasal polyps (PolypESS) - statistical analysis plan for a multicentre randomised controlled trial

2021 ◽  
Vol 4 (4) ◽  
pp. 58-65
Author(s):  
E.S. Lourijsen ◽  
M. Vleming ◽  
S. Reitsma ◽  
W.J. Fokkens
Keyword(s):  
Quality Of Life ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyps ◽  
Sinus Surgery ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Disease Specific ◽  
Specific Health

Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) afflicts 2-4% of the population and comes with a long time burden of disease and high societal costs. The current treatment consists of medical treatment alone or in combination with endoscopic sinus surgery. No consensus exists on the right timing and extent of disease that warrants surgery. Furthermore, there is lack of clinical knowledge about the benefit of surgery over medication only. The current study evaluates the clinical effectiveness and cost-effectiveness of endoscopic sinus surgery in addition to medical treatment versus medication alone in the adult patient group with nasal polyps (CRSwNP). Methods: The PolypESS trial is designed as a prospective, randomised, multicentre trial in adult patients with CRSwNP selected for primary or revision endoscopic sinus surgery by their otorhinolaryngologist. Patients are randomly assigned to endoscopic sinus surgery in addition to medication or medical therapy only. This paper details the statistical analysis plan (SAP) of this trial and was submitted before outcome data were available. Results: The primary outcome of the trial is disease-specific Health-Related Quality of Life quantified by the SNOT-22 at 12-months follow-up. Secondary outcomes consist of generic and disease-specific Health-Related Quality of Life, objective signs of disease and adverse events of treatment. Subgroup analyses will be performed to verify if treatment effects differ among patient phenotypes. Analyses will be completed according to this pre-specified SAP. The main analysis will be performed as a standard ITT analysis. Discussion: The PolypESS trial will show whether addition of endoscopic sinus surgery to medical treatment improves the disease-specific Health-Related Quality of Life quantified by the SNOT-22 at 12-months follow-up. Unforeseen deviations from the SAP at the time of analysis will be motivated and discussed in the final publication of the primary outcome of this study.

Sign in / Sign up

Export Citation Format

Share Document