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
Take Home Points:
- After endoscopic sinus surgery, patients experienced a significant improvement in quality of life.
- 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 the 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