Endoscopic Sinus Surgery Improves Sufferers Quality of Life

Over three-quarters of patients with chronic rhinosinusitis (CRS) experienced significant quality of life (QOL) improvements after undergoing endoscopic sinus surgery (ESS), according to a new study.

Researchers at the Oregon Health and Science University (OHSU; Portland, USA), Stanford University Medical Center (SUMC; CA, USA; stanfordhospital.org), and other institutions conducted a prospective, multi-institutional cohort study that 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. Computerized tomography (CT) scan, endoscopy score, and pre- and postoperative quality of life (QOL) data were collected. In addition, preoperative patient factors were evaluated for their ability to predict clinically significant outcomes so that surgeons could appropriately counsel patients and optimize surgical case selection.

The results of the study showed 72% to 76% 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 found to be significant predictors of improvement when multiple risk factors were accounted for in the predictive model. In all, primary ESS patients were twice as likely to improve after surgery as patients undergoing revision ESS. The study was published in the January 2010 issue of Otolaryngology - Head and Neck Surgery.

"These were patients who have chronic sinusitis so, by definition, they have at least three months of symptoms and they have evidence of an ongoing inflammation or infection of their nose and sinuses on either a CT scan or an examination of the nose and sinuses,” said lead author Timothy Smith, M.D., M.P.H., of OHSU. "Following the surgery, about 76% of patients had clinically significant improvement in quality of life.”

CRS is a debilitating form of sinusitis that affects 14-16% percent of the U.S. population, and 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. Consequently, CRS is often confused with the cold, flu, or allergies. 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 in the United States alone, with the primary goal of improving QOL.

Related Links:
Oregon Health and Science University
Stanford University Medical Center