Outcomes of sinus surgery in ambulatory patients with immune dysfunction

Ayesha N. Khalid, Jess C. Mace, Timothy Smith

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background: Previous outcomes studies of patients with chronic rhinosinusitis (CRS) have mostly excluded subjects with immunodeficiency or autoimmune disease. Although expert opinion suggests these patients are often refractory to therapy, outcomes after endoscopic sinus surgery (ESS) are not well delineated. We evaluated improvement in objective and quality of life (QoL) measures after ESS in adult patients treated in the ambulatory setting with immune dysfunction including immunodeficiency and autoimmune diseases. Methods: Patients with CRS associated with immune dysfunction (n = 22) were evaluated and matched 1:1 with control subjects from a prospective cohort in a nested case-control design. Preoperative computed tomography (CT) and pre-/postoperative endoscopic findings were recorded. Disease-specific QoL instruments (the Rhinosinusitis Disability Index [RSDI] and Chronic Sinusitis Survey [CSS]) were administered pre- and postoperatively. Results: Mean postoperative follow-up was similar for both cases (18.6 ± 6.6 months) and controls (18.4 ± 8.7 months). Preoperative CT and endoscopy scores (i.e., disease severity) were similar in both cases and controls. Postoperative endoscopy scores were significantly improved for both cases (p <0.001) and controls (p = 0.012). Both groups had similar preoperative and postoperative scores on the CSS; however, control subjects reported significantly worse RSDI baseline scores. Immunodeficiency and autoimmune cases and CRS controls experienced significant improvement in QoL after surgery (p ≤ 0.041). Conclusion: Immunodeficiency and autoimmune cases, in the ambulatory setting, present with similar severity of disease when compared with controls with CRS. We found similar improvements in both objective and QoL outcomes for case subjects and control subjects, suggesting that patients with immune dysfunction may experience similar benefit from ESS.

Original languageEnglish (US)
Pages (from-to)230-233
Number of pages4
JournalAmerican Journal of Rhinology and Allergy
Volume24
Issue number3
DOIs
StatePublished - May 2010

Fingerprint

Ambulatory Surgical Procedures
Quality of Life
Sinusitis
Endoscopy
Autoimmune Diseases
Tomography
Expert Testimony
Outcome Assessment (Health Care)
Surveys and Questionnaires
Therapeutics

Keywords

  • Ambulatory
  • Autoimmune
  • Chronic rhinosinusitis
  • Endoscopic surgery
  • Endoscopy
  • Immunodeficiency
  • Outcomes
  • Quality-of-life
  • Sinusitis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology

Cite this

Outcomes of sinus surgery in ambulatory patients with immune dysfunction. / Khalid, Ayesha N.; Mace, Jess C.; Smith, Timothy.

In: American Journal of Rhinology and Allergy, Vol. 24, No. 3, 05.2010, p. 230-233.

Research output: Contribution to journalArticle

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