Prevalence of polyp recurrence after endoscopic sinus surgery for chronic rhinosinusitis with nasal polyposis

DeConde, Adam S.; Mace, Jess C.; Levy, Joshua M.; Rudmik, Luke; Alt, Jeremiah A.; Smith, Timothy L.

doi:10.1002/lary.26391

Cited by 318 publications

(309 citation statements)

References 29 publications

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“…6–8 Adult (≥18 years of age) study participants were prospectively sampled from heterogeneous patient populations referred to tertiary, academic practices in North America for recalcitrant symptoms of CRS between March, 2011 and June, 2015. Diagnoses were confirmed by fellowship trained rhinologists using guidelines currently defined by the American Academy of Otolaryngology.…”

Section: Methodsmentioning

confidence: 99%

Investigating the minimal clinically important difference for SNOT‐22 symptom domains in surgically managed chronic rhinosinusitis

Chowdhury

Mace

Bodner

et al. 2017

Int Forum Allergy Rhinol

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116

123

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BACKGROUND Prior work has described five domains within the 22-item SinoNasal Outcomes Test (SNOT-22) that allow for stratification of symptoms into similar clusters that can be used to direct therapy. While the outcomes of various interventions on these symptom domains have been reported, minimal clinically important difference (MCID) values have not been previously investigated, limiting clinical interpretation of these results. METHODS The study was designed as secondary analysis of a prospective, multi-institutional, observational cohort. A total of 276 patients with medically refractory CRS who underwent surgical management were enrolled. Distribution-based methods (half-standard deviation, standard error of measurement, Cohen’s d, and the minimum detectable change) were used to compute MCID values for both SNOT-22 total and domain scores. The Medical Outcomes Study Short-Form 6D (SF-6D) health utility score was used to operationalize anchor-based associations using receiver-operating-characteristic (ROC) curves. RESULTS The mean MCID of several distribution-based methods for total SNOT-22 scores was 9.0, in agreement with previously published metrics. Average MCID values for the rhinologic, extra-nasal rhinologic, ear/facial, psychological, and sleep domain scores were: 3.8, 2.4, 3.2, 3.9, and 2.9, respectively. Anchor-based approaches with SF-6D did not have strong predictive accuracy across total SNOT-22 scores or domains (ROC areas under-the-curve ≤0.71), indicating weak associations between improvement in SNOT-22 scores and health utility as measured by the SF-6D. CONCLUSIONS This estimation of MCID values for the SNOT-22 symptom domains allows for improved clinical interpretation of results from past, present, and future rhinologic outcomes research.

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Section: Methodsmentioning

confidence: 99%

Investigating the minimal clinically important difference for SNOT‐22 symptom domains in surgically managed chronic rhinosinusitis

Chowdhury

Mace

Bodner

et al. 2017

Int Forum Allergy Rhinol

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116

123

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“…In patients with CRS and concomitant nasal polyps (CRSwNP), functional endoscopic surgery (FESS) may reduce asthma symptoms [132], however polyps tend to relapse [133]. Nasal polyps in severe asthma are predominantly eosinophilic, and treatment with anti-IL5 may be a future treatment option [134].…”

Section: Management Of Severe Asthmamentioning

confidence: 99%

Nordic consensus statement on the systematic assessment and management of possible severe asthma in adults

Porsbjerg

Ulrik

Skjold

et al. 2018

European Clinical Respiratory Journal

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Although a minority of asthma patients suffer from severe asthma, they represent a major clinical challenge in terms of poor symptom control despite high-dose treatment, risk of exacerbations, and side effects. Novel biological treatments may benefit patients with severe asthma, but are expensive, and are only effective in appropriately targeted patients. In some patients, symptoms are driven by other factors than asthma, and all patients with suspected severe asthma (‘difficult asthma’) should undergo systematic assessment, in order to differentiate between true severe asthma, and ‘difficult-to-treat’ patients, in whom poor control is related to factors such as poor adherence or co-morbidities. The Nordic Consensus Statement on severe asthma was developed by the Nordic Severe Asthma Network, consisting of members from Norway, Sweden, Finland, Denmark, Iceland and Estonia, including representatives from the respective national respiratory scientific societies with the aim to provide an overview and recommendations regarding the diagnosis, systematic assessment and management of severe asthma. Furthermore, the Consensus Statement proposes recommendations for the organization of severe asthma management in primary, secondary, and tertiary care.

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“…11 The author concluded that after endoscopic sinus surgery, recurrence of polyp was common among the patients. The authors found that the risk factors for recurrence of the polyp were previous history of surgery on polyps and worse preoperative polyposis severity.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of minimally invasive endoscopic sinus surgery in alleviating the symptom complex in chronic rhino-sinusitis

Reddy

2018

Int J Otorhinolaryngol Head Neck Surg

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Background: Early surgical intervention has been found to be better in terms of patient satisfaction compared even with the medical management. The objective of the study was to study effectiveness of minimally invasive endoscopic sinus surgery in alleviating the symptom complex in chronic rhino-sinusitis.Methods: Retrospective review of the chronic rhino-sinusitis data of 164 patients done, who undergone functional endoscopic sinus surgery with or without septoplasty between 2005 and 2013. Any recurrence of symptoms and radiological evidence recorded in the patient notes. The number of patients who undergone revision surgery also recorded. Results: The recurrence rate of symptoms and sinus disease was 20% (33 patients). There was no relation between the severity of the symptoms and the amount of disease seen in the CT scans. The two patients, who had purulent sinusitis, WERE completely relieved of their headaches and resumed their routine work soon after the operation. About 90% patients improved regarding nasal obstruction, 75% patients improved of nasal discharge, 60% patients showed improvement for sneezing. There were adhesions in about 6% patients and polyps recurred in 30% of patients. The recurrence of symptoms improved with medication in majority of patients.Conclusions: The meticulously performed functional endoscopic surgery effectively improved symptom complex. If properly performed it is effective in alleviating all the symptoms and decrease recurrence rate and complications can be kept at negligible levels. Hence it offers a clear advantage in reducing complications and recurrence rates in sinus disease.

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Prevalence of polyp recurrence after endoscopic sinus surgery for chronic rhinosinusitis with nasal polyposis

Cited by 318 publications

References 29 publications

Investigating the minimal clinically important difference for SNOT‐22 symptom domains in surgically managed chronic rhinosinusitis

Investigating the minimal clinically important difference for SNOT‐22 symptom domains in surgically managed chronic rhinosinusitis

Nordic consensus statement on the systematic assessment and management of possible severe asthma in adults

Effectiveness of minimally invasive endoscopic sinus surgery in alleviating the symptom complex in chronic rhino-sinusitis

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