Comparison of surgical outcomes between patients with unilateral and bilateral chronic rhinosinusitis

Beswick, Daniel M.; Mace, Jess C.; Chowdhury, Naweed I.; Alt, Jeremiah A.; Hwang, Peter H.; DeConde, Adam S.; Smith, Timothy L.

doi:10.1002/alr.22020

Cited by 12 publications

(11 citation statements)

References 29 publications

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“…Future investigations are needed to verify long-term rhinologic manifestations. Still another is we did not analyze influencing factors (e.g., laterality Beswick et al (2017), surgical extent Ayoub et al (2019), comorbid rhinitis, and concomitant surgical procedures, etc) in the current study. Considering their probable impacts on VAS rating and SNOT-22 scores, future studies are warranted to test their significance in the framework of EPLAs.…”

Section: Discussionmentioning

confidence: 98%

Clinical outcome of endonasal endoscopic prelacrimal approach in managing different maxillary pathologies

Lin

Chen

2020

PeerJ

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Background The aim of the study was to evaluate the treatment outcomes of endoscopic prelacrimal recess approaches (EPLAs) in managing different sinus pathologies, analyzing associated adverse events and post-treatment quality-of-life. Methods We enrolled 21 consecutive patients (22 lesions) who received endoscopic sinus surgical procedures with EPLAs in two tertiary medical institutes between 2015 and 2018. Quality-of-life and self-rated symptom severity data were collected using the 22-item Sino-Nasal Outcomes Test (SNOT-22) and 10-point visual analog scales (VAS), respectively. Results A total of 21 patients (mean age (standard deviation) 51.7 (14.5) years; 16(76.2%) male) were followed up for 12.7 months. The most common symptoms were nasal discharge and nasal airway obstructions. Nine lesions (40.9%) were sinonasal papilloma’s, seven lesions were other types of neoplasms (31.8%; five benign and two malignant), two were trauma-related (9.1%), and four inflammatory diseases (18.2%). Patients with non-papilloma lesions had higher presurgical SNOT-22 than those with papillomas (P-value = 0.021). After EPLAs, non-papilloma patients had significant improvements in SNOT-22 and VAS (P-values = 0.012 and 0.012, respectively), while those with papillomas had only marginally significant improvements in VAS (P-value = 0.061). The most common adverse events was temporary cheek/tooth numbness (n = 11), and patients with sinonasal papillomas were more likely to have post-treatment complications than those with other disease entities. Conclusions EPLAs were found to effectively manage various sinus diseases. Short-term life-quality improvements were promising. Future large-scale studies with longer follow-up periods are recommended.

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Section: Discussionmentioning

confidence: 98%

Clinical outcome of endonasal endoscopic prelacrimal approach in managing different maxillary pathologies

Lin

Chen

2020

PeerJ

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“…This is much higher than previous studies in which only 2.5% to 23.1% of patients with sinus imaging have unilateral disease. [7][8][9] This difference is likely attributable to a couple of different factors. First, the patients in our dataset were all seen in a tertiary rhinology practice.…”

Section: Discussionmentioning

confidence: 99%

“…Published data suggest that the incidence of unilateral sinus involvement ranges from 2.5% to 23.1% of patients undergoing sinus imaging. [7][8][9] A few studies have been published to date attempting to explore the differences in diagnoses in patients with bilateral versus unilateral disease, however many of these studies are small and have focused primarily on inflammatory diagnoses, without delineating the prevalence of neoplasms in each group. The most common diagnoses of patients presenting with unilateral disease are neoplastic disease (benign or malignant), antrochoanal polyp, and allergic fungal sinusitis.…”

Section: Introductionmentioning

confidence: 99%

Unilateral versus bilateral sinonasal disease: Considerations in differential diagnosis and workup

et al. 2019

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Objective Imaging findings play an important role in the workup and diagnosis of sinonasal disease. Unilateral versus bilateral involvement is a key finding that can differentiate between various diagnoses. Our objective is to characterize presenting symptoms, imaging findings, and most common diagnoses associated with unilateral versus bilateral sinonasal disease. Methods Patients who underwent surgical intervention for sinonasal disease at Emory University between May 2015 and December 2016 were included in the study. Information including demographic variables, comorbidities, presenting symptoms, imaging findings, and pathologic diagnosis was collected for each patient. Unilateral versus bilateral disease was determined by preoperative computer tomography and magnetic resonance imaging, and correlated to surgical and pathologic findings. Data was analyzed using quantitative methodologies and descriptive statistics. Results The study cohort consisted of 250 patients presenting for primary sinonasal surgery, including 110 patients with unilateral disease and 140 patients with bilateral disease. The most common diagnosis for patients with bilateral disease was chronic rhinosinusitis with nasal polyps (46%) followed by chronic rhinosinusitis without polyps (26%). For patients with unilateral disease the most common diagnoses were chronic rhinosinusitis without nasal polyps (21%), malignancy (19%), benign neoplasm (15%), and allergic fungal sinusitis (10%). There was a statistically significant association between unilateral sinonasal disease and the final diagnosis of benign neoplasm (OR = 7.8, P < .01) and malignancy (OR = 8, P < .01). Conclusion Patients with unilateral sinus disease on initial imaging are less likely chronic rhinosinusitis compared to patients with bilateral disease. This should be taken into consideration in the workup and management of patients with unilateral sinus disease. Level of Evidence 3 Laryngoscope, 130:E116–E121, 2020

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“…Frequently, only weak correlations between SNOT-22 total scores and objective CRS parameters, i.e., endonasal polyp scores [ 8 – 10 ] or computed tomography (CT) scores [ 11 ], have been observed [ 12 – 18 ]. In addition, recent meta-analyses suggested that patient-specific factors may also affect the degree of SNOT-22 change after treatment [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

The SNOT-22 factorial structure in European patients with chronic rhinosinusitis: new clinical insights

Dejaco

Riedl

Huber

et al. 2019

Eur Arch Otorhinolaryngol

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Purpose The sino-nasal outcomes test-22 (SNOT-22) represents the reference questionnaire to assess patients with chronic rhinosinusitis (CRS). As weak correlations between objective CRS parameters and SNOT-22 total score have been observed, factor analyses have aimed to identify underlying factorial structures. However, ambiguous factor loadings and problematic item-domain assignments have resulted. Moreover, such factor analyses have mainly been performed in non-European CRS patients, while European data remain sparse. This study thus sought to address these issues. Methods Principal component analysis and confirmatory factor analysis were performed from SNOT-22 questionnaires completed by European CRS patients. Goodness of fit, internal consistencies, and factor loadings were calculated. Item-domain assignment was based on statistical grounds and clinical meaningfulness. Additionally, this study investigated correlations between SNOT-22 domains and external reference criteria, including Lund–Mackay score, Lund–Naclerio score and the brief symptom inventory 18 (BSI-18). Results One hundred and thirty-four European CRS patients were included. Principal component analysis proposed four SNOT-22 domains (“ nasal symptoms ”, “ otologic symptoms ”, “ sleep symptoms ”, “ emotional symptoms ”), which explained 63.6% of variance. Observed item-domain-assignment differed from previously proposed item-domain assignments. All factor loadings were > 0.5, except “cough” (0.42) and “facial pain or pressure” (0.49). For confirmatory factor analysis, satisfactory goodness of fit (RMSEA = 0.66; CFI = 0.92; TLI = 0.90) and internal consistencies (Cronbach-α: total score = 0.93; domains = 0.75–0.91) were observed. Significant positive correlations were found between the “ nasal symptoms ” domain and both the Lund–Mackay score ( r = 0.48; p < 0.001) and the Lund–Naclerio score ( r = 0.27, p < 0.01). Significant positive correlations were also identified between “ emotional symptoms ” and BSI-18 total score ( r = 0.64, p < 0.001). Conclusions Principal component analysis performed for SNOT-22 questionnaires completed by European CRS patients indicated a different item-domain-assignment than previously reported. Confirmatory factor analysis suggested acceptable and clinically plausible psychometric properties for the resulting factorial structure. Significant correlations between the “ nasal symptoms ” and the “ emotional symptoms ” domains were observed with objective CRS parameters. The resulting factorial structure with different item-domain assignments may ...

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Comparison of surgical outcomes between patients with unilateral and bilateral chronic rhinosinusitis

Cited by 12 publications

References 29 publications

Clinical outcome of endonasal endoscopic prelacrimal approach in managing different maxillary pathologies

Clinical outcome of endonasal endoscopic prelacrimal approach in managing different maxillary pathologies

Unilateral versus bilateral sinonasal disease: Considerations in differential diagnosis and workup

The SNOT-22 factorial structure in European patients with chronic rhinosinusitis: new clinical insights

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