BACKGROUND: Prior study demonstrated that baseline 22-item Sino-Nasal Outcome Test (SNOT-22) aggregate scores accurately predict selection of surgical intervention in patients with chronic rhinosinusitis (CRS). Factor analysis of the SNOT-22 survey has identified five distinct domains that are differentially impacted by endoscopic sinus surgery (ESS). This study sought to quantify SNOT-22 domains in patient cohorts electing both surgical or medical management and postinterventional change in these domains. METHODS: CRS patients were prospectively enrolled into a multi-institutional, observational cohort study. Subjects elected continued medical management or ESS. SNOT-22 domain scores at baseline were compared between treatment cohorts. Postintervention domain score changes were evaluated in subjects with at least six-month follow-up. RESULTS: A total of 363 subjects were enrolled with 72 (19.8%) electing continued medical management, whereas 291 (80.2%) elected ESS. Baseline SNOT-22 domain scores were comparable between treatment cohorts in sinus-specific domains (rhinologic, extranasal rhinologic, and ear/facial symptoms; p > 0.050); however, the surgical cohort reported significantly higher psychological (mean ± standard deviation [SD]: 16.0 ± 8.4 vs 12.0 ± 7.1; p < 0.001) and sleep dysfunction (13.7 ± 6.8 vs 10.5 ± 6.2; p < 0.001) than the medical cohort. Effect sizes for ESS varied across domains with rhinologic and extranasal rhinologic symptoms experiencing the greatest gains (1.067 and 0.997, respectively), whereas psychological and sleep dysfunction experiencing the smallest improvements (0.805 and 0.818, respectively). Patients experienced greater mean improvements after ESS in all domains compared to medical management (p < 0.001). CONCLUSION: Subjects electing ESS report higher sleep and psychological dysfunction compared to medical management but have comparable sinus-specific symptoms. Subjects undergoing ESS experience greater gains compared to medical management across all domains; however, these gains are smallest in the psychological and sleep domains.
BACKGROUND: Prior study demonstrated that baseline 22-item Sino-Nasal Outcome Test (SNOT-22) aggregate scores accurately predict selection of surgical intervention in patients with chronic rhinosinusitis (CRS). Factor analysis of the SNOT-22 survey has identified five distinct domains that are differentially impacted by endoscopic sinus surgery (ESS). This study sought to quantify SNOT-22 domains in patient cohorts electing both surgical or medical management and postinterventional change in these domains. METHODS:CRSpatients were prospectively enrolled into a multi-institutional, observational cohort study. Subjects elected continued medical management or ESS. SNOT-22 domain scores at baseline were compared between treatment cohorts. Postintervention domain score changes were evaluated in subjects with at least six-month follow-up. RESULTS: A total of 363 subjects were enrolled with 72 (19.8%) electing continued medical management, whereas 291 (80.2%) elected ESS. Baseline SNOT-22 domain scores were comparable between treatment cohorts in sinus-specific domains (rhinologic, extranasal rhinologic, and ear/facial symptoms; p > 0.050); however, the surgical cohort reported significantly higher psychological (mean ± standard deviation [SD]: 16.0 ± 8.4 vs 12.0 ± 7.1; p < 0.001) and sleep dysfunction (13.7 ± 6.8 vs 10.5 ± 6.2; p < 0.001) than the medical cohort. Effect sizes for ESS varied across domains with rhinologic and extranasal rhinologic symptoms experiencing the greatest gains (1.067 and 0.997, respectively), whereas psychological and sleep dysfunction experiencing the smallest improvements (0.805 and 0.818, respectively). Patients experienced greater mean improvements after ESS in all domains compared to medical management (p < 0.001). CONCLUSION: Subjects electing ESS report higher sleep and psychological dysfunction compared to medical management but have comparable sinus-specific symptoms. Subjects undergoing ESS experience greater gains compared to medical management across all domains; however, these gains are smallest in the psychological and sleep domains.
Authors: Adam S DeConde; Jess C Mace; Jeremiah A Alt; Zachary M Soler; Richard R Orlandi; Timothy L Smith Journal: Int Forum Allergy Rhinol Date: 2014-09-18 Impact factor: 3.858
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Authors: Phillip R Purnell; Benjamin L Addicks; Habib G Zalzal; Scott Shapiro; Sijin Wen; Hassan H Ramadan; Vincent Setola; David P Siderovski Journal: Int Arch Allergy Immunol Date: 2019-05-28 Impact factor: 2.749
Authors: Adam S DeConde; Jeffrey D Suh; Jess C Mace; Jeremiah A Alt; Timothy L Smith Journal: Int Forum Allergy Rhinol Date: 2015-04-23 Impact factor: 3.858
Authors: Jose L Mattos; Luke Rudmik; Rodney J Schlosser; Timothy L Smith; Jess C Mace; Jeremiah Alt; Zachary M Soler Journal: Int Forum Allergy Rhinol Date: 2019-02-12 Impact factor: 3.858
Authors: Daniel M Beswick; Jess C Mace; Luke Rudmik; Zachary M Soler; Adam S DeConde; Timothy L Smith Journal: Int Forum Allergy Rhinol Date: 2018-07-28 Impact factor: 3.858
Authors: M Cole; K Bandeen-Roche; A G Hirsch; J R Kuiper; A S Sundaresan; B K Tan; R P Schleimer; R C Kern; B S Schwartz Journal: Allergy Date: 2018-05-21 Impact factor: 13.146