Luke Rudmik1, Zachary M Soler2, Jess C Mace3, Adam S DeConde4, Rodney J Schlosser2, Timothy L Smith3. 1. Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada. 2. Division of Rhinology and Sinus Surgery, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina. 3. Division of Rhinology and Sinus Surgery, Oregon Sinus Center, Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon. 4. Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of California San Diego, San Diego, CA, U.S.A.
Abstract
OBJECTIVES/HYPOTHESIS: The purpose of this study is to improve patient understanding of surgical outcomes while they make a preference-sensitive decision regarding electing endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS). STUDY DESIGN: Prospective observational cohort study. METHODS: Patients with CRS who elected ESS were prospectively enrolled into a multi-institutional, observational cohort study. Patients' were categorized into 10 preoperative Sino-Nasal Outcome Test (SNOT-22) groups based on 10-point increments beginning with a score of 10 and ending at 110. The proportion of patients achieving a SNOT-22 minimal clinically important difference (MCID) (9 points) and the percentage of relative improvement (%) for each preoperative SNOT-22 group were calculated. A subgroup analysis based on polyp status was performed. RESULTS: A total of 327 patients were included in this study. Patients with a SNOT-22 score between 10 and 19 had the lowest chance of achieving an MCID (37.5%) and received a relative mean worsening of their quality of life (QoL) after ESS (+18.8%). Patients with a SNOT-22 score greater than 30 obtained a greater than 75% chance of achieving an MCID, and there was a relative improvement of 45% in QoL (all < -44.9%) after ESS. Outcomes from the polyp status subgroup analysis were similar to the findings from the overall cohort. CONCLUSION: Outcomes from this study suggest that patients with a preoperative SNOT-22 score higher than 30 points receive a greater than 75% chance of achieving an MCID and on average obtain a 45% relative improvement in their QoL after ESS. Patients with SNOT-22 score of less than 20 did not experience improved QoL from ESS.
OBJECTIVES/HYPOTHESIS: The purpose of this study is to improve patient understanding of surgical outcomes while they make a preference-sensitive decision regarding electing endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS). STUDY DESIGN: Prospective observational cohort study. METHODS:Patients with CRS who elected ESS were prospectively enrolled into a multi-institutional, observational cohort study. Patients' were categorized into 10 preoperative Sino-Nasal Outcome Test (SNOT-22) groups based on 10-point increments beginning with a score of 10 and ending at 110. The proportion of patients achieving a SNOT-22 minimal clinically important difference (MCID) (9 points) and the percentage of relative improvement (%) for each preoperative SNOT-22 group were calculated. A subgroup analysis based on polyp status was performed. RESULTS: A total of 327 patients were included in this study. Patients with a SNOT-22 score between 10 and 19 had the lowest chance of achieving an MCID (37.5%) and received a relative mean worsening of their quality of life (QoL) after ESS (+18.8%). Patients with a SNOT-22 score greater than 30 obtained a greater than 75% chance of achieving an MCID, and there was a relative improvement of 45% in QoL (all < -44.9%) after ESS. Outcomes from the polyp status subgroup analysis were similar to the findings from the overall cohort. CONCLUSION: Outcomes from this study suggest that patients with a preoperative SNOT-22 score higher than 30 points receive a greater than 75% chance of achieving an MCID and on average obtain a 45% relative improvement in their QoL after ESS. Patients with SNOT-22 score of less than 20 did not experience improved QoL from ESS.
Authors: Timothy L Smith; Robert Kern; James N Palmer; Rodney Schlosser; Rakesh K Chandra; Alexander G Chiu; David Conley; Jess C Mace; Rongwei F Fu; James Stankiewicz Journal: Int Forum Allergy Rhinol Date: 2012-06-26 Impact factor: 3.858
Authors: Zachary M Soler; Luke Rudmik; Peter H Hwang; Jess C Mace; Rodney J Schlosser; Timothy L Smith Journal: Laryngoscope Date: 2013-07-15 Impact factor: 3.325
Authors: Richard M Rosenfeld; David Andes; Neil Bhattacharyya; Dickson Cheung; Steven Eisenberg; Theodore G Ganiats; Andrea Gelzer; Daniel Hamilos; Richard C Haydon; Patricia A Hudgins; Stacie Jones; Helene J Krouse; Lawrence H Lee; Martin C Mahoney; Bradley F Marple; Col John P Mitchell; Robert Nathan; Richard N Shiffman; Timothy L Smith; David L Witsell Journal: Otolaryngol Head Neck Surg Date: 2007-09 Impact factor: 3.497
Authors: Cezmi A Akdis; Claus Bachert; Cemal Cingi; Mark S Dykewicz; Peter W Hellings; Robert M Naclerio; Robert P Schleimer; Dennis Ledford Journal: J Allergy Clin Immunol Date: 2013-04-12 Impact factor: 10.793
Authors: Timothy L Smith; Jamie R Litvack; Peter H Hwang; Todd A Loehrl; Jess C Mace; Karen J Fong; Kenneth E James Journal: Otolaryngol Head Neck Surg Date: 2010-01 Impact factor: 3.497
Authors: Adam S DeConde; Jess C Mace; Vijay R Ramakrishnan; Jeremiah A Alt; Timothy L Smith Journal: Laryngoscope Date: 2017-08-04 Impact factor: 3.325
Authors: Adam S DeConde; Jess C Mace; Joshua M Levy; Luke Rudmik; Jeremiah A Alt; Timothy L Smith Journal: Laryngoscope Date: 2016-11-12 Impact factor: 3.325
Authors: Antti I Alakärppä; Timo J Koskenkorva; Petri T Koivunen; Olli-Pekka Alho Journal: Eur Arch Otorhinolaryngol Date: 2018-02-28 Impact factor: 2.503
Authors: Luke Rudmik; Timothy L Smith; Jess C Mace; Rodney J Schlosser; Peter H Hwang; Zachary M Soler Journal: Laryngoscope Date: 2015-09-15 Impact factor: 3.325
Authors: Toby O Steele; Jess C Mace; Raj Dedhia; Luke Rudmik; Timothy L Smith; Jeremiah A Alt Journal: Int Forum Allergy Rhinol Date: 2016-06-16 Impact factor: 3.858
Authors: N Oker; V Dupuch; P Herman; N Leclerc; P Vironneau; H Dang; J Majer; R Pastourel; Y Pavier; J-P Blancal; N Saroul; T Mom; R Kania; E Vicaut; L Gilain; B Verillaud Journal: Eur Arch Otorhinolaryngol Date: 2016-08-17 Impact factor: 2.503
Authors: Toby O Steele; Luke Rudmik; Jess C Mace; Adam S DeConde; Jeremiah A Alt; Timothy L Smith Journal: Int Forum Allergy Rhinol Date: 2016-02-08 Impact factor: 3.858