Outcomes Research in Rhinology: Chronic Rhinosinusitis

Abstract

Measuring ‘outcome’ in rhinology has been challenging investigators for decades. With the introduction of patient-based, quality of life outcomes, investigators have developed rhinologic-specific outcomes tools for allergic rhinitis, nasal obstruction, and chronic rhinosinusitis. Outcomes research in rhinology, however, is a nascent field. This article focuses on outcomes research in the management of chronic rhinosinusitis, especially as it relates to endoscopic sinus surgery. Quality of life outcomes are addressed not only as outcomes but as measures of disease and how they relate to other commonly used measures of disease such as CT and endoscopy.

Predictive Factors and Outcomes in Endoscopic Sinus Surgery for Chronic Rhinosinusitis

“…However, certain factors and comorbidities clearly impact preoperative measures, postoperative measures, and observed change in these outcomes. As we and others have previously noted, objective and QOL outcomes do not necessarily correlate in the pre‐ or postoperative period, but both provide important information regarding the patients' outcomes of ESS 2–4 . On the other hand, certain preoperative factors in the present study, ASA intolerance and depression, provide predictive value for postoperative endoscopy or QOL outcomes.…”

“…Chronic rhinosinusitis (CRS) is a common health condition in the United States affecting as many as 30 million and is the principal diagnosis in almost 2% of all office visits to physicians, resulting in more than 200,000 sinus procedures performed in the United States annually 1 . Patient symptoms and objective testing procedures play important roles in identifying appropriate surgical candidates, but discordance between objective testing and quality of life (QOL) has been observed by us and others 2–4 …”

Quality‐assessment of disease‐specific quality of life questionnaires for rhinitis and rhinosinusitis: a systematic review

“…In recent years, multiple other HRQL questionnaires have been developed specifically for rhinitis and rhinosinusitis. Several reviews described HRQL questionnaires concerning rhinitis and/or (rhino)sinusitis (15–22). Despite these laudable efforts, little attention has been paid to the quality of the psychometric properties of these questionnaires.…”

SNOT-22 Validation in Greek Patients

“…In their final assessment, physicians are confronted with this shortcoming and invited to use tools to evaluate the impact of the disease on the patients' QoL. These results of the QoL evaluation should be taken into account in the final decision for medical or surgical treatment [12]. We systematically use SNOT-22 as it covers a broad range of health-related QoL problems including physical problems, functional limitations and emotional consequences [13].…”

“…The total score (range: 0-110) was recorded in each set of investigations. The smallest change in the SNOT-22 score that can be detected by a patient is 8.9 points [12]. …”