Predictive Factors and Outcomes in Endoscopic Sinus Surgery for Chronic Rhinosinusitis

Smith, Timothy L.; Mendolia-Loffredo, Sabrina; Loehrl, Todd A.; Sparapani, Rodney; Laud, Purushottam W.; Nattinger, Ann B.

doi:10.1097/01.mlg.0000182825.82910.80

Cited by 293 publications

(394 citation statements)

References 17 publications

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“…1,2 Major depressive disorder affects 13 to 14 million Americans yearly, is a leading cause of disability in the population between 15 and 44 years old, and is estimated to cost $83 billion annually. 3,4 The prevalence of depression has been estimated to be between 5.4% and 8.9% in the general population, but is much more common in patients with chronic disease and has been estimated to be in the range of 14%-36%.…”

Section: Introductionmentioning

confidence: 99%

Role of Depression in Outcomes of Endoscopic Sinus Surgery

Litvack¹,

Mace²

2010

Otolaryngol.--head neck surg.

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OBJECTIVE-To prospectively measure the prevalence and effect of symptomatic depression on chronic rhinosinusitis (CRS) patients' quality of life (QOL), disease-severity, and outcomes of endoscopic sinus surgery (ESS). STUDY DESIGN-Prospective cohort studySETTING-Academic, tertiary care center SUBJECTS AND METHODS-Seventy-six patients with CRS were enrolled prior to ESS and followed post-operatively for a mean of 13.3 months(SD 5.5). Lund-MacKay CT score, LundKennedy endoscopy score, Patient Health Questionnaire-9 (PHQ-9), 2 disease-specific QOL instruments (Rhinosinusitis Disability Index [RSDI] and Chronic Sinusitis Survey [CSS]), and one general QOL instrument (Medical Outcomes Study Short Form-36 [SF-36]) were measured. Differences in outcome scores were analyzed using univariate and multivariate analyses. CONCLUSION-CRS patients with depression had worse baseline QOL than other CRS patients, but experienced comparable postoperative improvement in QOL after ESS. Interestingly, depression severity significantly improved after ESS. RESULTS-Only

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Section: Introductionmentioning

confidence: 99%

Role of Depression in Outcomes of Endoscopic Sinus Surgery

Litvack¹,

Mace²

2010

Otolaryngol.--head neck surg.

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“…4 The endoscopic approach requires the expertise of a two surgeon team composed of an otolaryngologist and a neurosurgeon, each of whom performs essential portions of the procedure, to provide a safe approach to anterior skull base lesions. Although sinonasal outcomes 1 after endoscopic sinus surgery have been previously studied, [5][6][7] this is the first case series that specifically examines the postoperative sinonasal symptoms and outcomes for patients undergoing transnasal endoscopic skull base surgery. These symptoms were quantified using the established Sinonasal Outcomes Test-20 (SNOT-20) originally developed by Piccirillo to study rhinosinusitis patients.…”

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confidence: 99%

Evolution of Sinonasal Symptoms Following Endoscopic Anterior Skull Base Surgery

et al. 2010

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To assess the severity and evolution of sinonasal symptoms in patients following endoscopic anterior skull base surgery to define the typical postoperative course. Design: Cross sectional study. Participants include 69 patients who underwent endoscopic skull base surgery by a dual surgeon team (otolaryngologist and neurosurgeon) from January 2008 to August 2009. Main outcome measures: Sinonasal Outcomes Test (SNOT)-20 survey scores at preoperative and at three postoperative time points. An ordinal logistic regression model was used to analyze the data, summarizing the relationship between the outcome (SNOT score) and the predictor (time point) using an odds ratio. Scores for the symptoms of need to blow nose, sneezing, runny nose, postnasal discharge, thick nasal discharge, ear fullness, and facial pain showed significant worsening at the early postoperative time point. These symptoms showed significant improvement over time; however, scores for post nasal discharge remained high at the late time period compared with baseline. All patients will experience considerable sinonasal symptoms following transnasal endoscopic skull base surgery. Postnasal discharge and thick nasal discharge improve significantly over time. Symptoms approach baseline by 6 to 9 months following surgery.

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“…In previous studies, note that the revision surgery rate ranges from 19% to 63% [34][35][36]. Risk factors for revision surgery include: ASS-intolerance [37], bronchial asthma [38], allergy [39] and nasal polyps [40].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Endonasal Endoscopic Sinus Surgery on Patients with Chronic Pulmonary Diseases

et al. 2017

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Abstract:Introduction: The impact of endoscopic sinus surgery on bronchial asthma has been studied by several groups. According to the latest studies, patients with chronic obstructive pulmonary disease (COPD) seem to have frequent symptoms of chronic rhinosinusitis. Our study compares the impact of endoscopic sinus surgery on both the upper and lower airways of patients with bronchial asthma as well as those with COPD. Methods: This study includes 43 patients (bronchial asthma, n = 32, COPD, n = 11) undergoing surgical treatment for chronic rhinosinusitis at the ENT-Department, University of Homburg (Homburg, Germany). To assess the effect of sinus surgery, the Sino-Nasal Outcome Test 20 German Adapted Version (SNOT-20 GAV) and St. George's Respiratory Questionnaire (SGRQ) were used both pre-and postoperatively. Results: Both SNOT-20 (p < 0.001) and SGRQ (p = 0.021) scores improved significantly after sinus surgery. The postoperative improvement in bronchial asthma and COPD was similar in both groups, indicating no difference of the diseases in regards to postoperative symptom improvement. There was no difference indicated in SNOT-20 GAV or SGRQ when grouping patients by polyps, aspirin (ASS) intolerance, allergies, eosinophilia or previous surgery. Conclusions: The treatment of chronic rhinosinusitis by sinus surgery may help to improve the therapy outcome of patients with bronchial asthma as well as patients with COPD.

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Predictive Factors and Outcomes in Endoscopic Sinus Surgery for Chronic Rhinosinusitis

Abstract: Surgical management of CRS was associated with significant improvement on objective and QOL measures; however, specific patient factors, in particular ASA and depression, predict poorer outcome. Preoperative CT may be a predictor of endoscopic and QOL outcome and deserves further study.

Cited by 293 publications

References 17 publications

Role of Depression in Outcomes of Endoscopic Sinus Surgery

Role of Depression in Outcomes of Endoscopic Sinus Surgery

Evolution of Sinonasal Symptoms Following Endoscopic Anterior Skull Base Surgery

The Impact of Endonasal Endoscopic Sinus Surgery on Patients with Chronic Pulmonary Diseases

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