Peak nasal inspiratory flow correlates with quality of life in functional endoscopic sinus surgery

Whitcroft, Katherine L.; Andrews, Peter; Randhawa, Premjit S

doi:10.1111/coa.12859

Cited by 25 publications

(28 citation statements)

References 24 publications

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“…Five RCTs [14][15][16][17][18] and 25 RWE studies 65 reported mean baseline SNOT-22 scores in the moderate range. Five RCTs [19][20][21][22][23] and 17 RWE studies [48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64] reported severe mean baseline SNOT-22 scores. These findings were consistent with the treatment plan for CRSwNP provided by Fokkens et al 92 , which recommended surgery as treatment for patients with more severe symptoms or with polyps that are recalcitrant to medical management.…”

Section: Stratification Of Snot-22 Scores Prior To Surgerymentioning

confidence: 99%

Systematic literature review of humanistic and economic burdens of chronic rhinosinusitis with nasal polyposis

Chen

Zhou

Emmanuel

et al. 2020

Current Medical Research and Opinion

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Objectives: We conducted a systematic literature review (SLR) of randomized controlled trials and real-world evidence (RWE) studies to determine the humanistic (e.g. health-related/disease-specific quality of life [QOL]) and economic (e.g. direct and indirect costs) burdens of chronic rhinosinusitis with nasal polyposis (CRSwNP). Methods: The SLR adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Embase, MEDLINE and Evidence-Based Medicine Reviews databases were searched using OVID. Relevant studies involving adult patients with CRSwNP published between 1 January 2008 and 16 February 2019 were included, with relevant conference abstracts from 1 January 2017, onward. Results: Sino-Nasal Outcomes Test (SNOT)-22 was the most frequently used disease-specific healthrelated QOL/patient-reported outcomes instrument for patients with CRSwNP. Baseline SNOT-22 scores ranged from 25 to 73 for surgical candidates and from 14 to 56 for medically managed patients with CRSwNP. Mean baseline EuroQol-5 Dimensions (EQ-5D) index for patients with CRSwNP ranged from 0.81 to 0.86, and mean baseline Short Form-6 Dimensions (SF-6D) ranged from 0.67 to 0.75. Three months (EQ-5D) and 5 years (SF-6D) post-endoscopic sinus surgery (ESS), rates increased from 0.81 to 0.89 and from 0.69 to 0.80, respectively. One year post-diagnosis, patients with CRSwNP had significantly more systemic prescriptions, underwent significantly more medical procedures, demonstrated greater health care resource utilization and had significantly greater mean health care costs compared with matched controls (all p < .001). Overall, for patients with initial ESS, CRSwNP was associated with higher disease-related expenditures compared with CRS without nasal polyposis (NP), even for patients who did not undergo revision surgery. Conclusions: This SLR identified substantial humanistic burden among surgery candidates. RWE shows that surgeries were used to treat relatively more severe CRSwNP patients as recommended by guidelines. Patient QOL is improved significantly after surgery; however, there is a lack of evidence on patients with revision surgery. Surgery is also associated with higher costs, and the presence of NP was a predictor of revision surgery. Patients with CRSwNP demonstrate greater health care resource utilization and costs compared to those with CRS without NP. Costs associated with different severity of CRSwNP and revision surgery need to be assessed further.

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Section: Stratification Of Snot-22 Scores Prior To Surgerymentioning

confidence: 99%

Systematic literature review of humanistic and economic burdens of chronic rhinosinusitis with nasal polyposis

Chen

Zhou

Emmanuel

et al. 2020

Current Medical Research and Opinion

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“…It could therefore be argued that the inferior turbinate being the larger structure and more involved with the nasal vascular regulated nasal cycle will also result in greater postdecongestant changes. Conversely, bilateral NIPF has been shown to significantly increase following functional endoscopic sinus surgery (FESS) in addition to correlating with improved quality of life in patients [31] which would imply that more drastic treatment regimens would be required to see a change in NIPF in CRS. Another study did suggest that CRS patients may require a more long term course of decongestants to be effective, compared to allergic rhinitis [32].…”

Section: Discussionmentioning

confidence: 99%

Assessing nasal obstruction with the nasal acoustic device: a pilot study on distinguishing between subjects with and without chronic rhinosinusitis

Tan

Whitcroft

et al. 2019

Preprint

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This article aims to demonstrate the concept and potential of a novel diagnostic device -the nasal acoustic device (NAD), which captures the nasal breathing sounds over the ala on both sides of the nose. Using the newly defined inspiratory nasal acoustic score (INA score), the unique characteristics of the nasal breathing sounds can be quantified and used for diagnostic purposes.In this pilot study, the NAD was compared with the well-established nasal inspiratory peak flow meter (NIPF) to try to distinguish between subjects with and without chronic rhinosinusitis (CRS).Measurements were made before and after nasal decongestants, which were applied to eliminate the nasal cycle. Patients were divided into two groups based on the presence or absence of CRS, irrespective of other pathological conditions being present.Based on the post-decongestant measurements, the sensitivity/specificity in distinguishing subjects who have CRS (n=11) from subjects who do not (n=29; of whom 13 were controls) were 70%/66% for the NIPF and 82%/79% for the NAD. The non-CRS groups showed statistically significant changes after decongestant for both methods, but the CRS group did not. The results firstly demonstrated that the CRS subjects in this cohort tended to be less responsive to decongestant and therefore the post-decongestant NIPF measurements provided a certain degree of diagnostic value in identifying CRS subjects, but it would appear the NAD better captured the unique sounds associated with CRS, providing a superior diagnostic capability. This study also demonstrates that the NAD can measure the improvement in the nasal airway following treatment effect.

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“…Pre-and post-decongestion testing can distinguish between nasal obstruction due to soft tissue and that due to fixed structural deformity (249,332,333) (Table 6). This can be useful in the appropriate selection of surgical procedures (314,334) as well as in the evaluation of nasal surgery outcomes (288,289,(334)(335)(336)(337)(338)(339)(340)(341) .…”

Section: Usesmentioning

confidence: 99%

European position paper on diagnostic tools in rhinology

Rimmer

Hellings

Lund

et al. 2019

Rhin

114

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is the official Journal of the European and International Rhinologic Societies and appears quarterly in March, June, September and December. Cited in Pubmed, Current Contents, Index Medicus, Exerpta Medica and Embase Founded in 1963 by H.A.E. van Dishoeck, Rhinology is a worldwide non-profit making journal. The journal publishes original papers on basic research as well as clinical studies in the major field of rhinology, including physiology, diagnostics, pathology, immunology, medical therapy and surgery of both the nose and paranasal sinuses. Review articles and short communications are also pulished. All papers are peer-reviewed. Letters-to-the-editor provide a forum for comments on published papers, and are not subject to editorial revision except for correction of English language. In-depth studies that are too long to be included into a regular issue can be published as a supplement. Supple ments are not subject to peer-review.

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Peak nasal inspiratory flow correlates with quality of life in functional endoscopic sinus surgery

Abstract: Changes in PNIF after FESS appear to best reflect improvements in quality of life in CRS as measured using the "SNOT-22" questionnaire.

Cited by 25 publications

References 24 publications

Systematic literature review of humanistic and economic burdens of chronic rhinosinusitis with nasal polyposis

Systematic literature review of humanistic and economic burdens of chronic rhinosinusitis with nasal polyposis

Assessing nasal obstruction with the nasal acoustic device: a pilot study on distinguishing between subjects with and without chronic rhinosinusitis

European position paper on diagnostic tools in rhinology

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