Modification of the lund‐kennedy endoscopic scoring system improves its reliability and correlation with patient‐reported outcome measures

Psaltis, Alkis J.; Li, Gang; Vaezeafshar, Reza; Cho, Kyu‐Sup; Hwang, Peter H.

doi:10.1002/lary.24654

Cited by 184 publications

(183 citation statements)

References 18 publications

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“…[63][64][65][66][67][68] A variety of scoring systems exist, but fundamentally each system comprises a weighted composite of some combination of the available endoscopic variables: extent and location of mucosal inflammation, presence and character of discharge, presence of scar, presence of crust, and middle turbinate (MT) position. Investigation of the test-retest reliability and content validity of several of these scales has been investigated.…”

Section: Ivc Measurement Of Disease Severitymentioning

confidence: 99%

“…Investigation of the test-retest reliability and content validity of several of these scales has been investigated. Unfortunately, at best, endoscopic scoring systems only weakly correlate with current QoL 64,67 and postoperative gains in QoL. 69 Although there is room for refinement of endoscopic scoring, endoscopic exams likely provide only a portion of the data required to accurately predict symptomatology.…”

Section: Ivc Measurement Of Disease Severitymentioning

confidence: 99%

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International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

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548

888

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Background:The body of knowledge regarding rhinosinusitis (RS) continues to expand, with rapid growth in number of publications, yet substantial variability in the quality of those presentations. In an effort to both consolidate and critically appraise this information, rhinologic experts from around the world have produced the International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR:RS). Methods:Evidence-based reviews with recommendations (EBRRs) were developed for scores of topics, using previously reported methodology. Where existing evidence was insufficient for an EBRR, an evidence-based review (EBR) was produced. The sections were then synthesized and the entire manuscript was then reviewed by all authors for consensus. Results:The resulting ICAR:RS document addresses multiple topics in RS, including acute RS (ARS), chronic RS (CRS) with and without nasal polyps (CRSwNP and CRSsNP), recurrent acute RS (RARS), acute exacerbation of CRS (AE-CRS), and pediatric RS. Conclusion:As a critical review of the RS literature, ICAR:RS provides a thorough review of pathophysiology and evidence-based recommendations for medical and surgical treatment. It also demonstrates the significant gaps in our understanding of the pathophysiology and optimal management of RS. Too o en the foundation upon which these recommendations are based is comprised of lowerlevel evidence. It is our hope that this summary of the evidence in RS will point out where additional research efforts may be directed. C 2016 ARS-AAOA, LLC. Key Words:rhinosinusitis; chronic rhinosinusitis; acute rhinosinusitis; recurrent acute rhinosinusitis; evidence-based medicine; systematic review; endoscopic sinus surgery List of Abbreviations Used

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Section: Ivc Measurement Of Disease Severitymentioning

confidence: 99%

Section: Ivc Measurement Of Disease Severitymentioning

confidence: 99%

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

Self Cite

548

888

View full text Add to dashboard Cite

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“…The MLK score is a simplified version of the LundKennedy endoscopic scoring system [16,17], which was original designed for describing endoscopic findings postoperatively after sinus surgery by scoring: polyps, edema, discharge, scaring and crusting. In the MLK score scaring and crusting are omitted, thus the score is calculated by evaluating each side of the nasal cavity for: polyps, edema, and discharge (0, 1 or 2) producing a sum score between 0 and 12 points.…”

Section: Outcome Measuresmentioning

confidence: 99%

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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“…17,18 They are also prevalent among rhinologists. The credible application of these staging systems, however, requires the use of an endoscope during patient examination.…”

Section: Discussionmentioning

confidence: 99%

Nasal endoscopy: an adjunct to patient selection for preoperative low-dose CT examination in chronic rhinosinusitis

Frączek

Guziński

Morawska-Kochman

et al. 2016

Dentomaxillofacial Radiology

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Objectives: The growing awareness of increased X-ray exposure to the public has led to the propagation of several methods for reducing the radiation dose during CT examination. Lowdose CT protocols do not, however, have an established role in pre-operative evaluation. The aim of this article was to assess the usefulness of nasal endoscopy in the selection of patients under pre-operative care for low-dose CT examination. Methods: A cadaver head was used to discover institutional minimum acceptable CT image quality and scanning settings. Then, 134 adult patients with chronic rhinosinusitis (CRS) were enrolled into the study and divided randomly into standard dose (120 kVp, 100 mAs) or lowdose CT groups (120 kVp, 45 mAs). Subjective assessment of the diagnostic image quality of the surgically relevant anatomical structures was compared using a five-point scale (from excellent to unacceptable) by a radiologist and sinus surgeon independently. Pathologic states of the nose were quantified according to the Lund-Kennedy endoscopic system (LKES) and Lildholdt's scale. Results: Image quality was similar in low-dose and standard dose groups in patients without polyps. The quality of 13% of scans from patients with polyps from the low-dose group and 4% from the standard dose group was in the range from moderate to poor. The quality of scans obtained with low milliamperes second (mAs) values worsened in patients with polyps in the middle meatus, but the difference was particularly pronounced compared with standard dose among subjects with Lildholdt's score above 2 ( p , 0.001). Correlation with LKES revealed that changes other than polyps (i.e. discharge, oedema, scaring or crusting) in the nasal cavity alone do not affect the image quality. Interobserver agreement in both groups was very high. Conclusions: Low-dose scanning should be promoted as the screening imaging method of choice in patients with suspected CRS. Furthermore, low mAs value examination can be performed pre-operatively without fear of significant image quality deterioration in uncomplicated CRS patients without polyps, or with minor changes in nasal endoscopy. Standard dose CT, which provides a better identification of bony landmarks, minimizes diagnostic errors and risk to patients, so it might be considered in those with polyps below the middle turbinate.

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Modification of the lund‐kennedy endoscopic scoring system improves its reliability and correlation with patient‐reported outcome measures

Cited by 184 publications

References 18 publications

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

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

Nasal endoscopy: an adjunct to patient selection for preoperative low-dose CT examination in chronic rhinosinusitis

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