Chronic sinusitis patients experience improved quality of life after endoscopic sinus surgery

Jan 01, 2010

Upwards of 76 percent of patients with chronic rhinosinusitis (CRS) experienced significant quality of life (QOL) improvements after undergoing endoscopic sinus surgery (ESS), according to new research in the January 2010 issue of Otolaryngology - Head and Neck Surgery.

CRS is a debilitating form of sinusitis that can lead to significant physical symptoms as well as substantial functional and emotional impairment. Symptoms of CRS include stuffy nose, sinus pain and pressure, headache, and sneezing, and CRS is often confused with the cold, flu, or allergies. According to the National Health Interview Survey, CRS affects 14-16 percent of the U.S. population and has significant socioeconomic implications, with annual direct costs of $4.3 billion. Also, patients with sinusitis score lower in QOL measures of bodily pain and social functioning than patients with congestive , angina, , or back pain. Due to the chronic nature of the disease, and the relatively poor response of some patients to initial medical therapies, patients with CRS undergo 500,000 surgical procedures annually, with the primary goal of improving QOL.

The prospective, multi-institutional analyzed a total 302 patients with CRS from three medical centers between July 2004 and December 2008 and followed the patients for approximately one and a half 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 optimize surgical case selection.

Results of the study showed 72 -76 percent 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 note 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.

Developed in the 1950s, ESS involves the insertion of the endoscope, a thin fiber-optic tube, into the nose for a direct visual examination of the openings into the sinuses. With state of the art micro-telescopes and instruments, abnormal and obstructive tissues are then removed. Some advantages of the procedure are that the surgery is less extensive, there is often less removal of normal tissues, and it can frequently be performed on an outpatient basis.

Explore further: US orders farms to report pig virus infections

Provided by American Academy of Otolaryngology -- Head and Neck Surgery

4.5 /5 (2 votes)
add to favorites email to friend print save as pdf

Related Stories

Depression a common consequence of chronic rhinosinusitis

Oct 07, 2009

The existence of depression in patients with chronic rhinosinusitis (CRS) is common and under-reported, according to new research presented at the 2009 American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) ...

Recommended for you

US orders farms to report pig virus infections

21 hours ago

The U.S. government is starting a new program to help monitor and possibly control the spread of a virus that has killed millions of pigs since showing up in the country last year.

Foreigner dies of MERS in Saudi

22 hours ago

A foreigner has died after she contracted MERS in the Saudi capital, the health ministry said on announced Friday, bringing the nationwide death toll to 73.

Vietnam battles fatal measles outbreak

Apr 18, 2014

Vietnam is scrambling to contain a deadly outbreak of measles that has killed more than 100 people, mostly young children, and infected thousands more this year, the government said Friday.

New clues on tissue scarring in scleroderma

Apr 18, 2014

A discovery by Northwestern Medicine scientists could lead to potential new treatments for breaking the cycle of tissue scarring in people with scleroderma.

User comments : 0

More news stories

Treating depression in Parkinson's patients

A group of scientists from the University of Kentucky College of Medicine and the Sanders-Brown Center on Aging has found interesting new information in a study on depression and neuropsychological function in Parkinson's ...

Airbnb rental site raises $450 mn

Online lodging listings website Airbnb inked a $450 million funding deal with investors led by TPG, a source close to the matter said Friday.

Health care site flagged in Heartbleed review

People with accounts on the enrollment website for President Barack Obama's signature health care law are being told to change their passwords following an administration-wide review of the government's vulnerability to the ...