Voice-Related Quality of Life in Patients with Chronic Rhinosinusitis

Abstract

Objective: Chronic rhinosinusitis (CRS) has long been associated with vocal dysfunction. However, studies quantifying the presence of voice dysfunction in CRS patients or the effects of functional endoscopic sinus surgery (FESS) are sparse. The goal of this study was to determine the voice-related quality of life in patients undergoing FESS for CRS using the validated Voice Related Quality of Life Survey (VRQL). We correlated the preoperative VRQL scores to the Sino-Nasal Outcome Test (SNOT-22) scores, and we determined the effect of FESS on postoperative VRQL scores. Methods: Consecutive patients undergoing FESS were preoperatively administered both the VRQL and the SNOT-22 surveys. Spearman (ρ) and Pearson ( r) correlation coefficients were calculated. The VRQL was mailed to patients postoperatively between 3 and 6 months. The paired t-test was used to compare pre- and post-FESS scores. Results: A total of 102 patients were enrolled, and 81 patients completed the two surveys. A total of 51 (62.9%) patients had raw VRQL score ≥ 10, signifying presence of significant vocal symptoms. The mean ± standard deviation (SD) raw VRQL score of the entire study population was 12.4 ± 4.6, and the mean SNOT-22 score was 37.8 ± 19.2. The Spearman correlation coefficient between VRQL and the total SNOT-22 score was 0.34 ( P =.002), and the Pearson correlation coefficient was 0.36 ( P = .001). Both correlations were similar, demonstrating that increasing severity of CRS symptoms correlates with decreasing voice-related quality of life (QOL). Seventy patients completed the postoperative survey for an 86% retention rate. Thirty-six of these patients had abnormal preoperative VRQL scores, and these patients improved significantly after FESS. The mean preoperative versus postoperative raw scores were 15.2 ± 5.6 versus 12.5 ± 4.1, respectively ( P = .003). Conclusion: This study demonstrates the increasing presence of vocal complaints with increasing severity of CRS. It also demonstrates that VRQL scores improve after FESS in those patients with preoperative vocal complaints. Level of Evidence: IV

Correlation of chronic rhinosinusitis‐related symptoms with computed tomography subsite

“…While we have previously demonstrated that both earand voice-related symptoms are common in patients with CRS, our study is the first to report the lack of correlation between ETDQ-7 score and VRQoL score with the CT-based severity. 11,12 Our hypothesis that certain symptoms might correlate more with posteriorly versus anteriorly draining sinuses was disproven.…”

Gender‐related differences in outcomes after endoscopic sinus surgery

“…For example, CRS has been shown to be a risk factor for both voice disorders and Eustachian tube dysfunction. 4,5 In this study we sought to identify gender-specific differences after functional endoscopic sinus surgery (FESS) on voice-related, Eustachian tube, and sinonasal QOL.…”

“…The 22‐item Sino‐Nasal Outcome Test (SNOT‐22) test has been widely used to evaluate sinonasal quality of life (QOL); however, the SNOT‐22 is not an exhaustive evaluation of symptoms related to CRS. For example, CRS has been shown to be a risk factor for both voice disorders and Eustachian tube dysfunction 4,5 . In this study we sought to identify gender‐specific differences after functional endoscopic sinus surgery (FESS) on voice‐related, Eustachian tube, and sinonasal QOL.…”