Gender‐specific analysis of outcomes from endoscopic sinus surgery for chronic rhinosinusitis

140

Background: Reported revision rates for endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS) vary significantly. Several investigations examining revision rates for ESS have been limited by duration of follow-up, academic centers, or small surgeon cohorts. The objective of this study was to define the long-term revision rates for ESS and to determine those unique patient factors that increase the risk of revision ESS. Methods:The Utah Population Database was queried for Current Procedural Terminology codes for ESS from 1996 to 2016. Patient demographics and comorbid diagnoses were collected. Revision rates and risk factors for surgery were determined by Cox proportional hazard modeling. Results:A total of 29,934 patients were identified, with a mean length of follow-up of 9.7 years. The long-term revision rate was found to be 15.9%. The mean time between surgeries decreased with higher number of revision surgeries. The time between the first and second surgery was 4.39 years and the time between the fourth and fi h surgery decreased to 2.18 years. Female gender, older age at first surgery, nasal polyps, comorbid asthma, allergy, and a family history of CRS all increased the risk of requiring revision surgery (p < 0.001). Conclusion:The long-term revision rate for ESS exceeds 15% and the time between revision surgeries decreased with each additional surgery being performed. Unique patient factors increased the risk of requiring revision ESS. Understanding patients' risk for revision surgery may help physicians select and counsel patients with CRS undergoing ESS. C 2018 ARS-AAOA, LLC.

Section: Discussionmentioning

confidence: 99%

Long‐term revision rates for endoscopic sinus surgery

Smith

Orlandi

Oakley

et al. 2018

140

“…While ESS may have been performed in these cohorts for recurrent acute sinusitis, mucoceles, etc., and polyp status may have been underreported (based on diagnosis and coding oversight), it is logical to assume that many of these procedures—primary or recurrent—were conducted on patients with CRSsNP. In our own series of CRS patients undergoing ESS in a tertiary care practice, CRSsNP patients comprise approximately one‐half the number of subjects …”

mentioning

confidence: 99%

SNOT‐22–based clusters in chronic rhinosinusitis without nasal polyposis exhibit distinct endotypic and prognostic differences

Lal

Hopkins

Divekar

2018

Self Cite

“…Of note, 55.2% of all patients electing ESS were male with a significantly higher proportion of males in the 50 years and older group. Prior research by Lal et al . showed that men report significantly lower SNOT‐22 scores when compared to women with a decline in SNOT‐22 scores with age for both sexes.…”

Section: Discussionmentioning

confidence: 93%

Impact of age on outcomes following endoscopic sinus surgery for chronic rhinosinusitis

Crosby

Jones

Palmer

et al. 2019

Background: Chronic rhinosinusitis (CRS) is a common condition that affects people of all ages and negatively impacts quality of life. The goal of this study was to identify differences in outcomes by age following endoscopic sinus surgery (ESS) for CRS utilizing 22-item Sino-Nasal Outcome Test (SNOT-22) scores.Methods: Data from 1252 adult CRS patients electing to undergo ESS (2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018) were collected retrospectively. The median age of 50 years was used to divide the data into 2 groups for comparison of the impact of age on SNOT-22 scores at 0, 3, and 6 months a er surgery. Changes in SNOT-22 scores were analyzed using a mixed models analysis. Results:A er adjusting for gender, race, polyp status, and number of prior ESSs, patients younger than 50 years had a higher mean pre-ESS SNOT-22 score (44.0) compared to those of at least 50 years of age (38.9). Among patients younger than 50 years, SNOT-22 scores declined by 20.7 points at 3 months post-ESS and 16.1 points at 6 months post-ESS. The rate of change between the dichotomized age groups was not significantly different at 3 and 6 months post-ESS (p = 0.7952 and p = 0.1057, respectively). Conclusion:Both age groups showed significant and durable improvement in SNOT-22 scores a er ESS. Patients younger than 50 years of age have higher pre-ESS SNOT-22 scores, but converge to the same SNOT-22 scores by 3 months post-ESS. The rate of change of SNOT-22 scores is not different between those younger than 50 years and those of at least 50 years. C 2019 ARS-AAOA, LLC.