Long-term outcomes of endoscopic sinus surgery in the management of adult chronic rhinosinusitis

Timothy Smith, Rodney J. Schlosser, Jess C. Mace, Jeremiah A. Alt, Daniel M. Beswick, Adam S. DeConde, Kara Y. Detwiller, Jose L. Mattos, Zachary M. Soler

Research output: Contribution to journalArticle

2 Citations (Scopus)

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.

Original languageEnglish (US)
JournalInternational Forum of Allergy and Rhinology
DOIs
StatePublished - Jan 1 2019

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Reoperation
Quality of Life
Health
Patient Satisfaction
Asthma
Endoscopy
Therapeutics

Keywords

  • chronic disease
  • outcome assessment (health care)
  • quality of life
  • sinusitis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology

Cite this

Long-term outcomes of endoscopic sinus surgery in the management of adult chronic rhinosinusitis. / Smith, Timothy; Schlosser, Rodney J.; Mace, Jess C.; Alt, Jeremiah A.; Beswick, Daniel M.; DeConde, Adam S.; Detwiller, Kara Y.; Mattos, Jose L.; Soler, Zachary M.

In: International Forum of Allergy and Rhinology, 01.01.2019.

Research output: Contribution to journalArticle

Smith, Timothy ; Schlosser, Rodney J. ; Mace, Jess C. ; Alt, Jeremiah A. ; Beswick, Daniel M. ; DeConde, Adam S. ; Detwiller, Kara Y. ; Mattos, Jose L. ; Soler, Zachary M. / Long-term outcomes of endoscopic sinus surgery in the management of adult chronic rhinosinusitis. In: International Forum of Allergy and Rhinology. 2019.
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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.",
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AU - Schlosser, Rodney J.

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AU - Beswick, Daniel M.

AU - DeConde, Adam S.

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AB - 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.

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