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Observational Study
. 2021 Jun 8;21(1):288.
doi: 10.1186/s12893-021-01269-1.

Pattern of symptom improvement following endoscopic sinus surgery for chronic rhinosinusitis

Salma S Al Sharhan  1 , Mohammed H Al Bar  2 , Shahad Y Assiri  2 , Assayl R AlOtiabi  2 , Deemah M Bin-Nooh  2 , Fozia K AlSugair  2 , Nada F AlRashidi  2 , Abdulmalik S AlSaied  2 , Amal A Alghamdi  3
Affiliations
Observational Study

Pattern of symptom improvement following endoscopic sinus surgery for chronic rhinosinusitis

Salma S Al Sharhan et al. BMC Surg. .

Abstract

Background: Chronic rhinosinusitis (CRS) is a common inflammation of the nose and the paranasal sinuses. Intractable CRS cases are generally treated with endoscopic sinus surgery (ESS). Although the effect of ESS on CRS symptoms has been studied, the pattern of symptom improvement after ESS for CRS is yet to be investigated. The aim of this study was to determine the magnitude and sequence of symptom improvement after ESS for CRS, and to assess the possible preoperative factors that predict surgical outcomes in CRS patients.

Methods: This was a longitudinal prospective study of 68 patients who had CRS (with or without nasal polyps). The patients underwent ESS at King Fahd Hospital of the University, Al Khobar, Saudi Arabia. The Sino-nasal Outcome Test-22 (SNOT-22) questionnaire was used for assessment at four time points during the study: pre-ESS, 1-week post-ESS, 4 weeks post-ESS, and 6 months post-ESS.

Results: The difference between the mean scores recorded for the five SNOT-22 domains pre-ESS and 6 months post-ESS were as follows: rhinologic symptoms (t-test = 7.22, p-value = < 0.001); extra-nasal rhinologic symptoms (t-test = 4.87, p-value = < 0.001); ear/facial symptoms (t-test = 6.34, p-value = < 0.001); psychological dysfunction (t-test = 1.99, p-value = 0.049); and sleep dysfunction (t-test = 5.58, p-value = < 0.001). There was a significant difference between the mean scores recorded for the five domains pre-ESS and 6 months post-ESS. Rhinologic symptoms had the largest effect size (d = 1.12), whereas psychological dysfunction had the least effect size (d = 0.24). The only statistically significant difference in the SNOT-22 mean scores recorded 4 weeks post-ESS was observed between allergic and non-allergic patients (t = - 2.16, df = 66, p = 0.035).

Conclusion: Understanding the pattern of symptom improvement following ESS for CRS will facilitate patient counselling and aid the optimization of the current treatment protocols to maximize surgical outcomes and quality of life.

Level of evidence: Prospective observational.

Keywords: Chronic rhinosinusitis; Nasal polyps; Pattern of symptoms; Quality of life.

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Conflict of interest statement

There are no conflicts of competing interest to be disclosed regarding this paper.

Figures

Fig. 1
Fig. 1
Line graph showing the trend of the rhinologic-related symptoms as measured with the five domains of the SNOT-22
See this image and copyright information in PMC

References

    1. Hastan D, Fokkens WJ, Bachert C, et al. Chronic rhinosinusitis in Europe—an underestimated disease. A GA2LEN study. Allergy. 2011;66:1216–1223. doi: 10.1111/j.1398-9995.2011.02646.x. - DOI - PubMed
    1. Fokkens WJ. European position paper on rhinosinusitis and nasal polyps. Rhinology. 2020;58:1–464. doi: 10.4193/Rhin20.401. - DOI - PubMed
    1. Rudmik L, Smith TL, Schlosser RJ, et al. Productivity costs in patients with refractory chronic rhinosinusitis. Laryngoscope. 2014;124:2007–2012. doi: 10.1002/lary.24630. - DOI - PMC - PubMed
    1. Stankiewicz J, Tami T, Truitt T, et al. Impact of chronic rhinosinusitis on work productivity through one-year follow-up after balloon dilation of the ethmoid infundibulum. Int Forum Allergy Rhinol. 2011;1:38–45. doi: 10.1002/alr.20008. - DOI - PubMed
    1. Halawi AM, Smith SS, Chandra RK. Chronic rhinosinusitis: epidemiology and cost. Allergy Asthma Proc. 2013;34:328–334. doi: 10.2500/aap.2013.34.3675. - DOI - PubMed

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