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

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 longterm outcomes (>10 years) a er 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-oflife (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: Fi y-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 a er 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. C 2019 ARS-AAOA, LLC. Key Words: sinusitis; chronic disease; outcome assessment (health care); quality of life How to Cite this Article: Smith TL, Schlosser RJ, Mace JC, et al. Long-term outcomes of endoscopic sinus surgery in the management of adult chronic rhinosinusitis. Int Forum Allergy Rhinol. 2019;9:831-841.C hronic rhinosinusitis (CRS) is a common disease, with substantial morbidity identified by using quality-

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Ethmoid‐to‐maxillary opacification ratio: a predictor of postoperative olfaction and outcomes in nasal polyposis?

“…Study participants included adult human subjects previously recruited for an observational, investigator‐monitored research study funded by the National Institute on Deafness and Other Communication Disorders (NIH Grant 2R01 DC005805), conducted between March 2011 and June 2015. Additional findings from this study cohort have been published elsewhere 11‐16 . Participants were prospectively enrolled via invitation from a patient population referred to 4 academic rhinology practices located in North America, including Oregon Health and Science University (OHSU, Portland, OR), Stanford University (Palo Alto, CA), the Medical University of South Carolina (Charleston, SC), and the University of Calgary (Calgary, AB, Canada).…”

Guidance for contemporary use of biologics in management of chronic rhinosinusitis with nasal polyps: discussion from a National Institutes of Health–sponsored workshop

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