Timothy L Smith1, Rodney J Schlosser2, Jess C Mace1, Jeremiah A Alt3, Daniel M Beswick4, Adam S DeConde5, Kara Y Detwiller1, Jose L Mattos6, Zachary M Soler2. 1. Department of Otolaryngology-Head & Neck Surgery, Oregon Sinus Center, Oregon Health & Science University, Portland, OR. 2. Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, SC. 3. Sinus and Skull Base Surgery Program, Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Utah, Salt Lake City, UT. 4. Department of Otolaryngology, University of Colorado, Aurora, CO. 5. Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of California San Diego, San Diego, CA. 6. Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology and Endoscopic Sinus Surgery, University of Virginia, Charlottesville, VA.
Abstract
BACKGROUND: There is a striking lack of long-term, prospective outcomes data for endoscopic sinus surgery (ESS) in chronic rhinosinusitis (CRS) using validated instruments. Our primary objective in this study was to report long-term outcomes (>10 years) after ESS for CRS obtained by prospective data collection. METHODS: An observational cohort (n = 59) of adult patients with CRS electing ESS was enrolled between 2004 and 2008. Long-term, disease-specific quality-of-life (QOL) outcomes, health utility values (HUV), revision surgery rate, development of asthma, and patient expectations/satisfaction with outcomes of ESS were examined using descriptive statistics and simple fixed-effects linear modeling. RESULTS: Fifty-nine adult patients were followed for 10.9 years (±13.8 months), on average. Mean QOL significantly improved between baseline and 6 months and remained durable to 10 years. HUV improved to normal. A 17% revision surgery rate within the 10-year follow-up period was observed with a 25% revision rate in CRS with polyposis. New-onset asthma after ESS occurred at a rate of 0.8%/year. Patient satisfaction with ESS outcomes was generally high. CONCLUSIONS: Ten-year prospective outcomes of ESS for CRS demonstrate that the initial clinically significant improvements in QOL seen 6 months postoperatively are durable over the long term. Over 75% of patients reported clinically significant long-term QOL and HUV improvement. HUV returned to normal. Revision surgery rate was 17% and worse postoperative endoscopy scores within 18 months of initial ESS were associated with higher likelihood of revision surgery. Most patients would pursue ESS again and recommend the procedure to other patients considering this treatment option.
BACKGROUND: There is a striking lack of long-term, prospective outcomes data for endoscopic sinus surgery (ESS) in chronic rhinosinusitis (CRS) using validated instruments. Our primary objective in this study was to report long-term outcomes (>10 years) after ESS for CRS obtained by prospective data collection. METHODS: An observational cohort (n = 59) of adult patients with CRS electing ESS was enrolled between 2004 and 2008. Long-term, disease-specific quality-of-life (QOL) outcomes, health utility values (HUV), revision surgery rate, development of asthma, and patient expectations/satisfaction with outcomes of ESS were examined using descriptive statistics and simple fixed-effects linear modeling. RESULTS: Fifty-nine adult patients were followed for 10.9 years (±13.8 months), on average. Mean QOL significantly improved between baseline and 6 months and remained durable to 10 years. HUV improved to normal. A 17% revision surgery rate within the 10-year follow-up period was observed with a 25% revision rate in CRS with polyposis. New-onset asthma after ESS occurred at a rate of 0.8%/year. Patient satisfaction with ESS outcomes was generally high. CONCLUSIONS: Ten-year prospective outcomes of ESS for CRS demonstrate that the initial clinically significant improvements in QOL seen 6 months postoperatively are durable over the long term. Over 75% of patients reported clinically significant long-term QOL and HUV improvement. HUV returned to normal. Revision surgery rate was 17% and worse postoperative endoscopy scores within 18 months of initial ESS were associated with higher likelihood of revision surgery. Most patients would pursue ESS again and recommend the procedure to other patients considering this treatment option.
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: Adam S DeConde; Jess C Mace; Jeremiah A Alt; Rodney J Schlosser; Timothy L Smith; Zachary M Soler Journal: Int Forum Allergy Rhinol Date: 2014-07-12 Impact factor: 3.858
Authors: Rodney J Schlosser; Kristina Storck; Timothy L Smith; Jess C Mace; Luke Rudmik; Arash Shahangian; Zachary M Soler Journal: Int Forum Allergy Rhinol Date: 2015-10-13 Impact factor: 3.858
Authors: Daniel M Beswick; Timothy L Smith; Jess C Mace; Jeremiah A Alt; Nyssa F Farrell; Vijay R Ramakrishnan; Rodney J Schlosser; Zachary M Soler Journal: Int Forum Allergy Rhinol Date: 2020-06-18 Impact factor: 3.858
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Authors: Robert Naclerio; Fuad Baroody; Claus Bachert; Benjamin Bleier; Larry Borish; Erica Brittain; Geoffrey Chupp; Anat Fisher; Wytske Fokkens; Philippe Gevaert; David Kennedy; Jean Kim; Tanya M Laidlaw; Jake J Lee; Jay F Piccirillo; Jayant M Pinto; Lauren T Roland; Robert P Schleimer; Rodney J Schlosser; Julie M Schwaninger; Timothy L Smith; Bruce K Tan; Ming Tan; Elina Toskala; Sally Wenzel; Alkis Togias Journal: J Allergy Clin Immunol Pract Date: 2020-03-04
Authors: Amarbir S Gill; Kristine A Smith; Huong Meeks; Gretchen M Oakley; Karen Curtin; Laurie LeClair; Heather Howe; Richard R Orlandi; Jeremiah A Alt Journal: Int Forum Allergy Rhinol Date: 2021-02-24 Impact factor: 5.426