The Sinus and Nasal Quality of Life Survey (SN-5) in the Management of Pediatric Chronic Rhinosinusitis: A systematic review and meta-analysis

Ni, Jonathan; Kompelli, Anvesh; Nguyen, Shaun A.; Schlosser, Rodney J.; Clemmens, Clarice S.; Soler, Zachary M.

doi:10.1016/j.ijporl.2018.06.010

Cited by 19 publications

(20 citation statements)

References 33 publications

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“…To date, the SN-5 and SNOT 20/22 instrument have both been validated, with the SN-5 specifically validated in a pediatric cohort in 2003, 35 and are commonly used as patient reported outcome measures to determine the severity of chronic sinusitis using multiple domains. [35][36][37] Their use in studies measuring outcome in pediatric chronic sinusitis has increased over time to include over half of studies over the last decade, although there is still heterogeneity in outcome measures used overall. Although any outcome measure has inherent strengths and weaknesses associated with its use, the use of common instrumental scales facilitates pooling of data through reduction of inherent bias.…”

Section: Discussionmentioning

confidence: 99%

“…Prior systematic reviews have demonstrated that there is still a need for further surgical outcome studies that control baseline patient characteristics and utilize these scales. 36 The pathophysiology of chronic sinusitis involves chronic inflammation that can be secondary to various etiologies. The most commonly studied special population were cystic fibrosis patients, a cohort who commonly have chronic sinusitis but are difficult to manage.…”

Section: Discussionmentioning

confidence: 99%

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Review and Analysis of Research Trends in Surgical Treatment of Pediatric Chronic Sinusitis

Shetty

Soh

Kahn

et al. 2020

Am J Rhinol�Allergy

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Background Chronic sinusitis is a common otolaryngologic complaint with a significant impact on patients’ quality of life. There is current debate and differences in quality of evidence regarding the best surgical management approach to pediatric chronic sinusitis. Objective To investigate changes in publishing trends over time in surgical management of pediatric chronic sinusitis. Methods A systematic literature review was conducted in January 2019 using Embase, PubMed, and Web of Science, of all articles that included surgical treatments for pediatric chronic sinusitis. Publications were grouped into 3 time periods: pre-1998, 1999–2008, and 2009–2018. In addition, a subgroup of publications pertaining to endoscopic sinus surgery, balloon sinuplasty, and adenoidectomy were grouped into 2-year periods since 1988 to compare the number of publications on each topic and to examine overall trends. Results A total of 327 abstracts were included in the data collection and analysis. There was an overall significant increase in total number of publications ( P < .0001), total number of authors ( P = .001), and comparison studies ( P = .003) from pre-1989 to 2018. Relative number of prospective studies, systemic review, and case studies/expert opinions have not significantly increased over time when comparing decades ( P > .05). Among the surgery types, functional endoscopic sinus surgery has the most amount of publications regardless of year despite a statistically significant increase in publications pertaining to balloon sinuplasty in the pediatric literature from 1999–2008 to 2009–2018 ( P = .001). Conclusions Studies on pediatric chronic sinusitis have increased significantly during each of the last 2 decades with an increase in the concomitant number of authors and comparison studies. Although most publications are still Level C or D evidence, there has been a nonsignificant increase in Level A evidence in the past decade. Endoscopic sinus surgery still remains the most studied procedure despite the recent increase in publications on balloon sinuplasty.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Review and Analysis of Research Trends in Surgical Treatment of Pediatric Chronic Sinusitis

Shetty

Soh

Kahn

et al. 2020

Am J Rhinol�Allergy

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“…16 A recent systematic review by Ni and colleagues established the efficacy of BCD, FESS, and medical management for pCRS; hence, this question was not addressed in this meta-analysis. 22 However, a noninferiority analysis was performed to ascertain the margin of efficacy for BCD when compared to surgical controls. In this noninferiority assessment, BCD was found to be inferior to other surgical controls in 2 of 3 studies (Gerber and Kennedy; 14 Thottam et al 12 ).…”

Section: Discussionmentioning

confidence: 99%

Balloon Catheter Dilation in Pediatric Chronic Rhinosinusitis: A Meta-analysis

Patel

O’Brien

Ramadan

et al. 2020

Am J Rhinol�Allergy

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Background Paranasal sinus balloon catheter dilation (BCD) represents a tool that has been shown to be safe in the management of pediatric chronic rhinosinusitis (pCRS); however, its efficacy compared to standard treatment regimens has not been well established. Objective The purpose of this meta-analysis was to evaluate the clinical utility of BCD in pCRS. Methods Articles reporting BCD for pCRS in patients under 18 years of age were identified via the following search terms: sinusitis OR rhinosinusitis AND balloon dilatation OR balloon dilation OR balloon sinuplasty OR sinuplasty AND adolescent OR children OR infant OR pediatric OR toddler. The primary outcome analyzed includes quality of life improvement as measured via Sinus and Nasal Quality of Life Survey (SN-5) or Sino-nasal Outcome Test (SNOT-22) scores. Results Eighty studies were abstracted; 10 studies were included for final qualitative analysis after dual investigator screening. Three studies described BCD with surgical controls, including adenoidectomy, saline irrigation, or maxillary antrostomy. Noninferiority was not demonstrated (ie, BCD is inferior) in 2 of 3 studies. Pooled analysis utilizing a random effects model revealed a decreased effect size yet no statistically significant difference between BCD and standard operative techniques as measured by quality of life measures ( g = −0.04, I2 = 41%). Conclusion This work highlights a lack of published evidence regarding the role of BCD in pCRS. Two of the 3 included studies demonstrated the inferiority of BCD when compared to other standard surgical interventions, whereas meta-analysis was unable to detect any statistically significant difference between standard treatment regimens. Future scientific investigations are necessary to assess the comparative effectiveness of BCD in pCRS.

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“…Given the growing number of published studies and reported complications, the goal of the current review was to comprehensively elucidate the efficacy and side effects of this technqiue. Studies of the impact of BCS on QoL in pediatric CRS were aggregated in a previously published meta-analysis [34]. The previous meta-analysis had a restricted search strategy and the analysis was based on 4 observational based studies.…”

Section: Discussionmentioning

confidence: 99%

“…Since EPOS 2012, a number of studies have been carried out to determine the efficacy of BCS in pediatric CRS [24,25,[28][29][30][31][32][33]. The majority of these studies were pooled in a previous meta-analysis [34], demonstrating that BCS can significantly improve CRS symptoms among the pediatric group using a parent-reported scale, Sino-Nasal 5 (SN-5) QoL questionnaire [24,28,29,35,36]. However, this previous review lacks randomized controlled trials and studies with long-term follow-ups.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of paranasal sinus balloon catheter dilation in pediatric chronic rhinosinusitis: A systematic review

Mirza

Shawli

Alandejani

et al. 2020

Journal of Otolaryngology - Head & Neck Surgery

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Objective Chronic rhinosinusitis (CRS) negatively affects quality of life (QoL), and balloon catheter sinuplasty (BCS) has shown good outcomes in adult patients. However, there has not been much research on the effects of BCS on pediatric patients. The objective of this review is to systematically assess the literature for studies demonstrating the effectiveness and safety of BCS in pediatric CRS patients. Data sources PubMed, Embase and Cochrane Library. Study selection We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis recommendations (PRISMA) to conduct our study. Observational- and interventional-based studies reporting efficacy and/or side effects of BCS among pediatric populations were included. Efficacy was evaluated by clinically reliable measures including Sino-Nasal 5 (SN-5) QoL scale. Antibiotic usage and revision surgery were also evaluated. Data extraction Articles were screened, and data were obtained. Study design, sample size and demographics, treated sinuses, criteria of inclusion, adjunct procedure(s), follow-up time, and outcomes measured were reported. Main findings Out of 112 articles identified, 10 articles were included: two interventional controlled trials and eight observational studies. All studies evaluating QoL by SN-5 showed a remarkable reduction in SN-5 score postoperatively. Improvement in the computed tomography (CT) and endoscopic findings for up to 1 year after operation was reported. Furthermore, the majority of patinets treated with BCS did not recieve any course of sinusitis-indicated antibiotics during long-term follow-up, and they had low surgical revision rates. Minor side effects were reported, most commonly synechia. Conclusion Available evidence suggests that BCS is safe and effective for the treatment of CRS in pediatric patients. Future randomized controlled studies with large sample size are warranted. Such studies can further determine the efficacy of BCS in managing children with CRS.

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The Sinus and Nasal Quality of Life Survey (SN-5) in the Management of Pediatric Chronic Rhinosinusitis: A systematic review and meta-analysis

Cited by 19 publications

References 33 publications

Review and Analysis of Research Trends in Surgical Treatment of Pediatric Chronic Sinusitis

Review and Analysis of Research Trends in Surgical Treatment of Pediatric Chronic Sinusitis

Balloon Catheter Dilation in Pediatric Chronic Rhinosinusitis: A Meta-analysis

Efficacy and safety of paranasal sinus balloon catheter dilation in pediatric chronic rhinosinusitis: A systematic review

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