Endoscopic Sinus Surgery Improves Quality of Life in Patients With Chronic Sinusitis
ALEXANDRIA, VA -- January 4, 2010 -- Upwards of 76% of patients with chronic rhinosinusitis (CRS) experienced significant quality of life (QOL) improvements after undergoing endoscopic sinus surgery (ESS), according to a study published in the January 2010 issue of the journal Otolaryngology-Head and Neck Surgery.

The prospective study analysed 302 patients with CRS from 3 medical centres between July 2004 and December 2008 and followed the patients for approximately 1.5 years postoperatively.

The goal of the study was to report outcomes of ESS using prospective, multi-institutional data from a large cohort and validated disease-specific and general health-related QOL instruments. In addition, preoperative patient factors were evaluated for their ability to predict clinically significant outcomes so that surgeons can appropriately counsel patients and optimise surgical case selection.

Results of the study showed 72% to 76% of patients with CRS and poor baseline QOL experienced clinically significant improvement in disease-specific QOL outcomes after ESS.

Clinical factors, including asthma, aspirin intolerance, and prior sinus surgery, as well as preoperative diagnostic testing were found to be important potential predictors of outcomes. However, few of these variables were significant predictors of improvement when multiple risk factors were accounted for in the predictive model.

Ultimately, primary ESS patients were twice as likely to improve after surgery as patients undergoing revision ESS, although a baseline measure of disease severity (endoscopy score) was worse in the revision ESS group.

The authors noted that although several previous studies have reported improvement in the large majority of patients undergoing ESS, these have been limited by retrospective data collection or unvalidated outcomes. Also, some prospective studies have reported improvement in mean QOL and symptom scores following ESS, but they did not define the proportion of patients that improved. They were largely single institution results, or had limited sample sizes for analysis.

SOURCE: American Academy of Otolaryngology -- Head and Neck Surgery