Long‐term outcomes from the English national comparative audit of surgery for nasal polyposis and chronic rhinosinusitis

Hopkins, Claire; Slack, R. W. T.; Lund, Valerie J.; Brown, Peter; Copley, Lynn P.; Browne, John

doi:10.1002/lary.20653

Cited by 258 publications

(294 citation statements)

References 13 publications

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“…Inflammation and CT scores are higher in CRSwNP (in patients in cluster 1) which does not seem to result in worse outcomes compared to male CRSsNP patients, and they are better than those of CRSsNP female patients. This confirms previous findings that CRSwNP patients demonstrate more satisfaction with surgical outcomes and suggests that comparison between mixed groups of CRS patients with and without nasal polyps is unhelpful [12]. …”

Section: Discussionsupporting

confidence: 79%

“…It has been suggested that, besides differences in symptom patterns, major phenotypes differ in the response to surgical or combined (surgical and drug) treatment [12]. Early recognition of patients who are refractory to long-term medical and surgical treatment may prevent repetitive unnecessary sinus surgery and potential complications of such procedures.…”

Section: Introductionmentioning

confidence: 99%

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Cluster Analysis of Chronic Rhinosinusitis Suggests Gender-Based Differences

Jurlin

Gregurić²,

Baudoin

et al. 2018

ORL

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Purpose: We aimed to evaluate the interaction between the overall severity of chronic rhinosinusitis (CRS) before treatment and subjective improvement following surgical or medical treatment. Procedures: A group of 97 patients with CRS completed the visual analog scale (VAS) symptom score and the Sino-Nasal Outcome Test 22 (SNOT-22) questionnaire in the moment of their sinus computerized tomography (CT) scan. Data were analyzed via a 2-step cluster analysis based on gender, polyp presence, CT scan, and VAS scores for symptoms. Results: There were 3 clusters: the first cluster comprised 37 female patients with CRS without nasal polyps (CRSsNP), the second cluster comprised 30 patients with CRS and NP (CRSwNP; 15 males and 15 females); and third cluster had 30 male patients with CRS without NP (CRSsNP). Different symptom patterns between clusters were identified. After adjustment for polyp presence, gender, eosinophilia (p = 0.021), and the SNOT-22 score (p = 0.005) were found to be better outcome predictors than the CT score (p = 0.26). Conclusion: Long-term patient satisfaction is significantly associated with the subjective symptom severity prior to treatment, i.e., postnasal drip and overall disease severity (SNOT-22 score), but not with the objective severity of the disease (CT score and inflammation).

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Section: Discussionsupporting

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Cluster Analysis of Chronic Rhinosinusitis Suggests Gender-Based Differences

Jurlin

Gregurić²,

Baudoin

et al. 2018

ORL

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“…As this study design set out to be representative of the daily clinical practice, it did not enable us to add a 1-year clinical followup. However, previous long-term studies have documented that the effects of ESS measured after 3-12 months, are likely to be sustained over a 5-year period [28,29].…”

Section: Strengths and Weaknessmentioning

confidence: 97%

Efficacy of ESS in chronic rhinosinusitis with and without nasal polyposis: a Danish cohort study

Lind

Joergensen

Lange

et al. 2015

Eur Arch Otorhinolaryngol

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Endoscopic sinus surgery (ESS) for patients with severe chronic rhinosinusitis (CRS) has become a well-established treatment in cases where medical therapy fails. Even though CRS patients are divided into two subgroups, CRS with nasal polyposis (CRSwNP) and CRS without nasal polyposis (CRSsNP), most studies present only results for the total cohort. This prospective cohort study evaluated the efficacy of ESS on both quality of life and olfactory function measures, in a cohort of Danish CRS patients diagnosed according to the EPOS criteria, with results analysed separately for the CRSwNP and CRSsNP subgroups. All 97 CRS patients who underwent ESS over an 18-month trial period were evaluated preoperative by SNOT-22 score, Sniffin' Sticks score, modified Lund-Kennedy endoscopic score and Lund-Mackay CT score. Patient outcomes were reevaluated at clinical follow-up 1 and 6 months postoperative. ESS efficiently and immediately improved quality of life for both CRSwNP and CRSsNP patients, with over 50 % reduction in SNOT-22 score 1 month after surgery, which sustained 6 months postoperative. Olfactory function measured by Sniffin' Sticks score showed overall improvement in both groups. ESS efficiently improved quality of life in both CRSwNP and CRSsNP patients, and surgery lead to an overall improvement in olfactory function. However, a minor proportion of patients experienced deterioration in olfactory function after ESS.

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“…Usually the oedema phase takes approximately 30 days, and after three months the healing process is complete [20]. Baumann et al [21] and Hopkins et al [22] determined there was no difference or significant outcome of SNOT-20 GAV between the three month and the one year data collection results and the five year results. Not all patients in this study had preoperative medication for bronchial asthma or COPD.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Endonasal Endoscopic Sinus Surgery on Patients with Chronic Pulmonary Diseases

et al. 2017

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Abstract:Introduction: The impact of endoscopic sinus surgery on bronchial asthma has been studied by several groups. According to the latest studies, patients with chronic obstructive pulmonary disease (COPD) seem to have frequent symptoms of chronic rhinosinusitis. Our study compares the impact of endoscopic sinus surgery on both the upper and lower airways of patients with bronchial asthma as well as those with COPD. Methods: This study includes 43 patients (bronchial asthma, n = 32, COPD, n = 11) undergoing surgical treatment for chronic rhinosinusitis at the ENT-Department, University of Homburg (Homburg, Germany). To assess the effect of sinus surgery, the Sino-Nasal Outcome Test 20 German Adapted Version (SNOT-20 GAV) and St. George's Respiratory Questionnaire (SGRQ) were used both pre-and postoperatively. Results: Both SNOT-20 (p < 0.001) and SGRQ (p = 0.021) scores improved significantly after sinus surgery. The postoperative improvement in bronchial asthma and COPD was similar in both groups, indicating no difference of the diseases in regards to postoperative symptom improvement. There was no difference indicated in SNOT-20 GAV or SGRQ when grouping patients by polyps, aspirin (ASS) intolerance, allergies, eosinophilia or previous surgery. Conclusions: The treatment of chronic rhinosinusitis by sinus surgery may help to improve the therapy outcome of patients with bronchial asthma as well as patients with COPD.

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Long‐term outcomes from the English national comparative audit of surgery for nasal polyposis and chronic rhinosinusitis

Cited by 258 publications

References 13 publications

Cluster Analysis of Chronic Rhinosinusitis Suggests Gender-Based Differences

Cluster Analysis of Chronic Rhinosinusitis Suggests Gender-Based Differences

Efficacy of ESS in chronic rhinosinusitis with and without nasal polyposis: a Danish cohort study

The Impact of Endonasal Endoscopic Sinus Surgery on Patients with Chronic Pulmonary Diseases

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