Impact of mucosal eosinophilia and nasal polyposis on quality-of-life outcomes after sinus surgery

Zachary M. Soler, David Sauer, Jess Mace, Timothy Smith

Research output: Contribution to journalArticle

110 Citations (Scopus)

Abstract

Objective: Assess whether the presence of mucosal eosinophilia correlates with surgical outcomes in patients with chronic rhinosinusitis. Study Design: Prospective cohort. Setting: Tertiary medical center. Subjects and Methods: Adult patients with chronic rhinosinusitis were prospectively enrolled, and demographic data and medical comorbidities were recorded. Preoperative quality of life (QOL) was measured by the Chronic Sinusitis Survey (CSS), Rhinosinusitis Disability Index (RSDI), and Short Form-36 General Health Survey (SF-36). Sinus mucosal specimens were collected at the time of surgery and the degree of eosinophilia quantified. Postoperative QOL was measured, and differences in QOL improvement were compared between those with and without eosinophilia. Results: A total of 102 patients had both histopathological and QOL outcome data available for review. Follow-up averaged 16.5 months. Patients with eosinophilia showed significantly less improvement in the RSDI total (17.9 vs 25.0; P = 0.044), RSDI functional (5.7 vs 8.8; general health subscale; P = 0.018), CSS medication (3.6 vs 17.3; P = 0.013), SF-36 general health (0.6 vs 9.6; P = 0.008), SF-36 physical role (16.1 vs 34.7; P = 0.036), and SF-36 vitality (11.9 vs 21.2; P = 0.034) scales than those without eosinophilia. The greatest improvement in QOL was seen in patients without eosinophilia or polyps, with the least improvement seen in those with eosinophilia but without polyps. Conclusion: The presence of mucosal eosinophilia at the time of surgery consistently predicted less improvement in both disease-specific and general QOL compared with patients without eosinophilia. The impact of eosinophilia on outcomes was greatest for patients without nasal polyposis, a group that demonstrated the least improvement in QOL measures.

Original languageEnglish (US)
Pages (from-to)64-71
Number of pages8
JournalOtolaryngology - Head and Neck Surgery
Volume142
Issue number1
DOIs
StatePublished - Jan 2010

Fingerprint

Eosinophilia
Nose
Quality of Life
Sinusitis
Polyps
Health
Quality Improvement
Health Surveys
Comorbidity
Demography
Prospective Studies

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Surgery

Cite this

Impact of mucosal eosinophilia and nasal polyposis on quality-of-life outcomes after sinus surgery. / Soler, Zachary M.; Sauer, David; Mace, Jess; Smith, Timothy.

In: Otolaryngology - Head and Neck Surgery, Vol. 142, No. 1, 01.2010, p. 64-71.

Research output: Contribution to journalArticle

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abstract = "Objective: Assess whether the presence of mucosal eosinophilia correlates with surgical outcomes in patients with chronic rhinosinusitis. Study Design: Prospective cohort. Setting: Tertiary medical center. Subjects and Methods: Adult patients with chronic rhinosinusitis were prospectively enrolled, and demographic data and medical comorbidities were recorded. Preoperative quality of life (QOL) was measured by the Chronic Sinusitis Survey (CSS), Rhinosinusitis Disability Index (RSDI), and Short Form-36 General Health Survey (SF-36). Sinus mucosal specimens were collected at the time of surgery and the degree of eosinophilia quantified. Postoperative QOL was measured, and differences in QOL improvement were compared between those with and without eosinophilia. Results: A total of 102 patients had both histopathological and QOL outcome data available for review. Follow-up averaged 16.5 months. Patients with eosinophilia showed significantly less improvement in the RSDI total (17.9 vs 25.0; P = 0.044), RSDI functional (5.7 vs 8.8; general health subscale; P = 0.018), CSS medication (3.6 vs 17.3; P = 0.013), SF-36 general health (0.6 vs 9.6; P = 0.008), SF-36 physical role (16.1 vs 34.7; P = 0.036), and SF-36 vitality (11.9 vs 21.2; P = 0.034) scales than those without eosinophilia. The greatest improvement in QOL was seen in patients without eosinophilia or polyps, with the least improvement seen in those with eosinophilia but without polyps. Conclusion: The presence of mucosal eosinophilia at the time of surgery consistently predicted less improvement in both disease-specific and general QOL compared with patients without eosinophilia. The impact of eosinophilia on outcomes was greatest for patients without nasal polyposis, a group that demonstrated the least improvement in QOL measures.",
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