BACKGROUND: The purpose of this study was to determine long-term subjective outcome of endoscopic sinus surgery (ESS) for chronic sinusitis (CS) and to evaluate prognostic indicators for surgical treatment failure. METHODS: This is a prospective study of patients who underwent ESS for CS. Symptom assessment was performed using a visual analog scale at a pretreatment interview and then at regular intervals post-ESS for up to a 3-year period. The indicators for symptom scoring were nasal obstruction, facial pain, postnasal drip, anterior discharge, and anosmia/hyposmia. RESULTS: Data analysis indicates that ESS improves symptom scoring early on, but the effects begin to dissipate over time. Anosmia/hyposmia is the most severe symptom overall for all patient subgroups and recurs to a greater degree 3 years postoperatively in Samter's Triad sufferers (p = 0.006), asthmatic patients (p = 0.002), and those with a worse CT scan at presentation (p = 0.04). In addition, Triad sufferers who complain of nasal obstruction and anterior nasal discharge have a significant recurrence of their symptoms postoperatively (p = 0.04 and 0.001, respectively). CONCLUSION: Individuals must be warned that ESS may not be a long-term solution for CS because of its chronic nature. Patients are relieved of their symptoms initially; however, these tend to recur over a 3-year period. Samter's Triad is the strongest determinant of long-term treatment failure. Asthma also is a determinant of treatment failure, which lends credence to the notion of combined airway disease. Allergy was not a strong determinant of treatment failure in our study.
BACKGROUND: The purpose of this study was to determine long-term subjective outcome of endoscopic sinus surgery (ESS) for chronic sinusitis (CS) and to evaluate prognostic indicators for surgical treatment failure. METHODS: This is a prospective study of patients who underwent ESS for CS. Symptom assessment was performed using a visual analog scale at a pretreatment interview and then at regular intervals post-ESS for up to a 3-year period. The indicators for symptom scoring were nasal obstruction, facial pain, postnasal drip, anterior discharge, and anosmia/hyposmia. RESULTS: Data analysis indicates that ESS improves symptom scoring early on, but the effects begin to dissipate over time. Anosmia/hyposmia is the most severe symptom overall for all patient subgroups and recurs to a greater degree 3 years postoperatively in Samter's Triad sufferers (p = 0.006), asthmatic patients (p = 0.002), and those with a worse CT scan at presentation (p = 0.04). In addition, Triad sufferers who complain of nasal obstruction and anterior nasal discharge have a significant recurrence of their symptoms postoperatively (p = 0.04 and 0.001, respectively). CONCLUSION: Individuals must be warned that ESS may not be a long-term solution for CS because of its chronic nature. Patients are relieved of their symptoms initially; however, these tend to recur over a 3-year period. Samter's Triad is the strongest determinant of long-term treatment failure. Asthma also is a determinant of treatment failure, which lends credence to the notion of combined airway disease. Allergy was not a strong determinant of treatment failure in our study.
Authors: Timothy L Smith; Rodney J Schlosser; Jess C Mace; Jeremiah A Alt; Daniel M Beswick; Adam S DeConde; Kara Y Detwiller; Jose L Mattos; Zachary M Soler Journal: Int Forum Allergy Rhinol Date: 2019-06-17 Impact factor: 3.858
Authors: Whitney W Stevens; Anju T Peters; Annemarie G Hirsch; Cara M Nordberg; Brian S Schwartz; Dione G Mercer; Mahboobeh Mahdavinia; Leslie C Grammer; Kathryn E Hulse; Robert C Kern; Pedro Avila; Robert P Schleimer Journal: J Allergy Clin Immunol Pract Date: 2017-03-09
Authors: Whitney W Stevens; Elina Jerschow; Alan P Baptist; Larry Borish; John V Bosso; Kathleen M Buchheit; Katherine N Cahill; Paloma Campo; Seong H Cho; Anjeni Keswani; Joshua M Levy; Anil Nanda; Tanya M Laidlaw; Andrew A White Journal: J Allergy Clin Immunol Date: 2020-12-09 Impact factor: 10.793
Authors: Shannon C Wheeler; Amar Miglani; Nicholas L Deep; Marlene E Girardo; Michael Hinni; Devyani Lal Journal: Laryngoscope Investig Otolaryngol Date: 2019-04-23