Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Mar;144(3):446-51.
doi: 10.1177/0194599810391625. Epub 2011 Feb 1.

Role of depression in outcomes of endoscopic sinus surgery

Jamie R Litvack  1 , Jess Mace, Timothy L Smith
Affiliations

Role of depression in outcomes of endoscopic sinus surgery

Jamie R Litvack et al. Otolaryngol Head Neck Surg. 2011 Mar.

Abstract

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 study.

Setting: Academic, tertiary care center.

Subjects and methods: Seventy-six patients with CRS were enrolled prior to ESS and followed postoperatively for a mean (SD) of 13.3 (5.4) months. Lund-Mackay computed tomography score, Lund-Kennedy endoscopy score, Patient Health Questionnaire-9 (PHQ-9), 2 disease-specific QOL instruments (Rhinosinusitis Disability Index [RSDI] and Chronic Sinusitis Survey [CSS]), and 1 general QOL instrument (Medical Outcomes Study Short Form-36 [SF-36]) were measured. Differences in outcome scores were analyzed using univariate and multivariate analyses.

Results: Only 7 (9.2%) patients reported a history of depression, but 19 (25.0%) patients scored in the range of moderate or severe depression on the PHQ-9. Mean (SD) preoperative scores were significantly worse in depressed patients on the RSDI (62.7 [18.2] vs 45.3 [16.3]; P < .001) and 7 of 8 SF-36 domains (all P ≤ .011). Patients with depression significantly improved on both disease-specific QOL instruments (mean [SD] change; RSDI: 33.5 [24.7], P = .017; CSS: 25.0 [20.9], P = .012) and 3 SF-36 domains (all P ≤ .050). Postoperative change scores were not significantly different from patients without depression on the RSDI, CSS, or SF-36. Severity of depression significantly improved postoperatively in depressed patients (preoperative PHQ-9 scores: 13.4 [2.0] vs 6.1 [4.5], P = .017).

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.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Although both patients with and without depression experience similar improvement in QOL after sinus surgery, they do so from different baselines. ESS, endoscopic sinus surgery.
See this image and copyright information in PMC

References

    1. Smith TL, Mendolia-Loffredo S, Loehrl T, et al. Predictive factors and outcomes in endoscopic sinus surgery for chronic rhinosinusitis. Laryngoscope. 2005;115:2199–2205. - PubMed
    1. Smith TL, Litvack JR, Hwang PH, et al. Determinants of outcomes of sinus surgery: A multi-institutional prospective cohort study. Otolaryngol Head Neck Surg. 2010;142:55–63. - PMC - PubMed
    1. Kessler RC, Berflund P, Demler O, et al. The epidemiology of major depressive disorder. Results from the national comorbidity replication (NCS-R) JAMA. 2003;289:3095–3105. - PubMed
    1. Greenberg PE, Kessler RC, Birnbaum HG, et al. The economic burden of depression in the United States: how did it change between 1990 and 2000? J Clin Psychiatry. 2003;64:1465–1475. - PubMed
    1. Mann JJ. Drug Therapy: The Medical Management of Depression. NEJM. 2005;353(17):1819–1834. - PubMed

Publication types