Quality-of-life outcomes following multiple revision endoscopic sinus surgery

John D. Clinger, Jess C. Mace, Timothy Smith

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: Although overall success rates of endoscopic sinus surgery (ESS) range from 76.0% to 97.5%, ongoing or recurrent symptoms may require revision surgery. Previous studies have shown that revision status is not a predictor of outcomes following ESS, but no distinction has been made between patients undergoing a single or multiple revision procedure. The purpose of this study was to compare quality-of-life (QOL) outcomes and associated risk factors of patients undergoing primary ESS, first-revision ESS, and multiple-revision ESS (second, third, fourth, and fifth or more). Methods: Demographic and risk factor data were collected from a multi-institutional prospective cohort of 552 patients undergoing primary (n = 221) and revision (n = 331) ESS for chronic rhinosinusitis. Mean preoperative Lund-Mackay computed tomography (CT) scan scores, pre-/postoperative Lund-Kennedy endoscopy scores, Rhinosinusitis Disability Index (RSDI), and Chronic Sinusitis Survey (CSS) outcomes were analyzed using chi-square testing and 1-way analysis of variance (ANOVA). Results: Mean preoperative RSDI and CSS measurements were similar between primary ESS and all revision groups. Significantly more primary ESS patients met rigorous criteria for a minimally important difference in QOL improvement than revision ESS patients (73.8% vs 61.6%; p = 0.003). There was no significant difference in mean QOL improvement between revision groups (all p ≥ 0.174) even when comparing patients with and without nasal polyposis (all p ≥ 0.312). Conclusion: Generally, patients undergoing primary, first-revision, and multiple-revision ESS showed postoperative improvement in QOL scores. More primary ESS patients had significant QOL improvement compared to revision ESS patients. There were no significant differences in mean QOL improvement between any of the individual revision groups.

Original languageEnglish (US)
Pages (from-to)444-452
Number of pages9
JournalInternational Forum of Allergy and Rhinology
Volume2
Issue number6
DOIs
StatePublished - Nov 2012

Fingerprint

Quality of Life
Quality Improvement
Reoperation
Sinusitis
Nose
Endoscopy
Analysis of Variance
Tomography
Demography

Keywords

  • Chronic rhinosinusitis
  • Endoscopic sinus surgery
  • Nasal polyposis
  • Outcomes
  • Quality-of-life
  • Revision
  • Rhinology
  • Sinusitis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology

Cite this

Quality-of-life outcomes following multiple revision endoscopic sinus surgery. / Clinger, John D.; Mace, Jess C.; Smith, Timothy.

In: International Forum of Allergy and Rhinology, Vol. 2, No. 6, 11.2012, p. 444-452.

Research output: Contribution to journalArticle

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title = "Quality-of-life outcomes following multiple revision endoscopic sinus surgery",
abstract = "Background: Although overall success rates of endoscopic sinus surgery (ESS) range from 76.0{\%} to 97.5{\%}, ongoing or recurrent symptoms may require revision surgery. Previous studies have shown that revision status is not a predictor of outcomes following ESS, but no distinction has been made between patients undergoing a single or multiple revision procedure. The purpose of this study was to compare quality-of-life (QOL) outcomes and associated risk factors of patients undergoing primary ESS, first-revision ESS, and multiple-revision ESS (second, third, fourth, and fifth or more). Methods: Demographic and risk factor data were collected from a multi-institutional prospective cohort of 552 patients undergoing primary (n = 221) and revision (n = 331) ESS for chronic rhinosinusitis. Mean preoperative Lund-Mackay computed tomography (CT) scan scores, pre-/postoperative Lund-Kennedy endoscopy scores, Rhinosinusitis Disability Index (RSDI), and Chronic Sinusitis Survey (CSS) outcomes were analyzed using chi-square testing and 1-way analysis of variance (ANOVA). Results: Mean preoperative RSDI and CSS measurements were similar between primary ESS and all revision groups. Significantly more primary ESS patients met rigorous criteria for a minimally important difference in QOL improvement than revision ESS patients (73.8{\%} vs 61.6{\%}; p = 0.003). There was no significant difference in mean QOL improvement between revision groups (all p ≥ 0.174) even when comparing patients with and without nasal polyposis (all p ≥ 0.312). Conclusion: Generally, patients undergoing primary, first-revision, and multiple-revision ESS showed postoperative improvement in QOL scores. More primary ESS patients had significant QOL improvement compared to revision ESS patients. There were no significant differences in mean QOL improvement between any of the individual revision groups.",
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N2 - Background: Although overall success rates of endoscopic sinus surgery (ESS) range from 76.0% to 97.5%, ongoing or recurrent symptoms may require revision surgery. Previous studies have shown that revision status is not a predictor of outcomes following ESS, but no distinction has been made between patients undergoing a single or multiple revision procedure. The purpose of this study was to compare quality-of-life (QOL) outcomes and associated risk factors of patients undergoing primary ESS, first-revision ESS, and multiple-revision ESS (second, third, fourth, and fifth or more). Methods: Demographic and risk factor data were collected from a multi-institutional prospective cohort of 552 patients undergoing primary (n = 221) and revision (n = 331) ESS for chronic rhinosinusitis. Mean preoperative Lund-Mackay computed tomography (CT) scan scores, pre-/postoperative Lund-Kennedy endoscopy scores, Rhinosinusitis Disability Index (RSDI), and Chronic Sinusitis Survey (CSS) outcomes were analyzed using chi-square testing and 1-way analysis of variance (ANOVA). Results: Mean preoperative RSDI and CSS measurements were similar between primary ESS and all revision groups. Significantly more primary ESS patients met rigorous criteria for a minimally important difference in QOL improvement than revision ESS patients (73.8% vs 61.6%; p = 0.003). There was no significant difference in mean QOL improvement between revision groups (all p ≥ 0.174) even when comparing patients with and without nasal polyposis (all p ≥ 0.312). Conclusion: Generally, patients undergoing primary, first-revision, and multiple-revision ESS showed postoperative improvement in QOL scores. More primary ESS patients had significant QOL improvement compared to revision ESS patients. There were no significant differences in mean QOL improvement between any of the individual revision groups.

AB - Background: Although overall success rates of endoscopic sinus surgery (ESS) range from 76.0% to 97.5%, ongoing or recurrent symptoms may require revision surgery. Previous studies have shown that revision status is not a predictor of outcomes following ESS, but no distinction has been made between patients undergoing a single or multiple revision procedure. The purpose of this study was to compare quality-of-life (QOL) outcomes and associated risk factors of patients undergoing primary ESS, first-revision ESS, and multiple-revision ESS (second, third, fourth, and fifth or more). Methods: Demographic and risk factor data were collected from a multi-institutional prospective cohort of 552 patients undergoing primary (n = 221) and revision (n = 331) ESS for chronic rhinosinusitis. Mean preoperative Lund-Mackay computed tomography (CT) scan scores, pre-/postoperative Lund-Kennedy endoscopy scores, Rhinosinusitis Disability Index (RSDI), and Chronic Sinusitis Survey (CSS) outcomes were analyzed using chi-square testing and 1-way analysis of variance (ANOVA). Results: Mean preoperative RSDI and CSS measurements were similar between primary ESS and all revision groups. Significantly more primary ESS patients met rigorous criteria for a minimally important difference in QOL improvement than revision ESS patients (73.8% vs 61.6%; p = 0.003). There was no significant difference in mean QOL improvement between revision groups (all p ≥ 0.174) even when comparing patients with and without nasal polyposis (all p ≥ 0.312). Conclusion: Generally, patients undergoing primary, first-revision, and multiple-revision ESS showed postoperative improvement in QOL scores. More primary ESS patients had significant QOL improvement compared to revision ESS patients. There were no significant differences in mean QOL improvement between any of the individual revision groups.

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KW - Rhinology

KW - Sinusitis

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