 |
|
Symptom Outcomes After Endoscopic Sinus Surgery for Chronic Rhinosinusitis
Neil Bhattacharyya, MD
Arch Otolaryngol Head Neck Surg. 2004;130:329-333.
Objective To determine the effectiveness of endoscopic sinus surgery (ESS) for individual symptoms, medication use, and related factors in patients with chronic rhinosinusitis (CRS).
Design Nonrandomized, prospective, clinical trial.
Interventions Adult patients with medically refractory CRS were examined before ESS with the Rhinosinusitis Symptom Inventory to catalog major and minor symptoms, medication use, physician visits, and missed workdays due to CRS. After a minimum 6-month follow-up after ESS, patients were examined to determine response to therapy. After computation of Rhinosinusitis Symptom Inventory domains, comparisons were conducted and effect sizes were computed for the change in symptoms after surgery.
Results One hundred adults completed the examination, with a mean follow-up of 19.0 months. Before surgery, the mean major symptom scores ranged from 2.5 to 3.5 (Likert scale, from 0 [symptom absent] to 5 [maximum severity]) and the minor symptom scores ranged from 0.8 to 2.8. After surgery, statistically significant decreases in major and minor symptoms were noted (P<.001 for all). The largest effect sizes were noted for the decreases in facial pressure, congestion, nasal obstruction, rhinorrhea, and headache (absolute value of effect size >0.85 for all). Similarly, large effect sizes were noted for decreases in symptoms in the nasal (-1.30), facial (-1.13), and total (-1.25) symptom domains of the Rhinosinusitis Symptom Inventory. Medication use actually increased for topical nasal corticosteroids, but decreased for prescription antihistamines. A mean reduction of 1.1 antibiotic courses (mean decrease of 2.3 weeks taking antibiotics) was noted after ESS.
Conclusions Endoscopic sinus surgery provides significant symptom relief for the nasal and facial symptoms associated with CRS. Patients will often still require topical nasal corticosteroids for the management of their CRS, but can expect decreases in antibiotic requirements after ESS.
From the Division of Otolaryngology, Brigham and Women's Hospital, and the Department of Otology and Laryngology, Harvard Medical School, Boston, Mass. The author has no relevant financial interest in this article.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
The Demise of the Sinus Headache Is Premature
Chester
Arch Intern Med 2005;165:954-954.
FULL TEXT
Clinical Outcomes After Revision Endoscopic Sinus Surgery
Bhattacharyya
Arch Otolaryngol Head Neck Surg 2004;130:975-978.
ABSTRACT
| FULL TEXT
|
