LANDMARK: Quality of Life after sinus surgery

Determinants of outcomes of sinus surgery: a multi-institutional prospective cohort study.

Smith TL, Litvack JR, Hwang PH, Loehrl TA, Mace JC, Fong KJ, James KE

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(1):55-63.

Take Home Points:

  • After endoscopic sinus surgery, patients experienced a significant improvement in quality of life.

The Details:

    • This was a prospective, multi-institutional study looking at quality of life measures in patients with chronic rhinosinusitis refractory to medical management including antibiotics, oral, and topical steroids.
  • Each patient had preoperative endoscopy and CT scans and all patients filled out ┬áthe rhinosinusitis disability index (RSDI), chronic sinusitis survey (CSS), general quality of life instrument (SF-36) pre and post operatively.
    • Clinically significant change was determined to be one half of the standard deviation of the baseline QOL score.
    • 302 pts were followed for mean 17.4 months post operatively.
    • Post-operatively, patients had significant improvements on RSDI (15.8%, 18.9 points) and on CSS (21.2%, 21.2 points) (p<0.001).
    • SF-36 scores improved across all subscales (p<0.001).
    • A history of prior sinus surgery was the only predictor of poorer outcomes.
    • In patients with poor QOL scores, 71.7% improved on RSDI scores and 76.1% improved in CSS post-operatively after sinus surgery.
  • Patients undergoing primary sinus surgery were 2.1 times as likely to improve compared to patients undergoing revision sinus surgery