THE 2017 13<sup>TH</sup> ANNUAL DAVID W. KENNEDY, MD, LECTURE The evolution of outcomes in sinus surgery for chronic rhinosinusitis: past, present, and future

Smith, Timothy L.

doi:10.1002/alr.22026

Cited by 5 publications

(5 citation statements)

References 34 publications

(30 reference statements)

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“…In CRS, the primary surgical aims are: (1) relief of symptoms with improvement in QoL; (2) reduction in the amount of mucosal disease as well as enlargement of sinus drainage pathways for topical drug delivery; (3) avoidance of surgical complications; (4) prevention of complications related to untreated sinus disease 1771 . While the magnitude of the change in QoL before and after surgery is an important surgical outcome for ESS, 1772 patients are also more likely to undergo ESS if they report more severe symptoms 1773 . Therefore, the decision to recommend surgery for CRS should always take into consideration the severity of associated symptoms.…”

Section: Surgery For Chronic Rhinosinusitismentioning

confidence: 99%

International consensus statement on allergy and rhinology: rhinosinusitis 2021

Orlandi

Kingdom

Smith

et al. 2021

Int Forum Allergy Rhinol

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481

479

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I. Executive Summary Background The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS.

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Section: Surgery For Chronic Rhinosinusitismentioning

confidence: 99%

International consensus statement on allergy and rhinology: rhinosinusitis 2021

Orlandi

Kingdom

Smith

et al. 2021

Int Forum Allergy Rhinol

Self Cite

481

479

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“…Further, HUV outcomes are important both to evaluate the effectiveness of interventions for chronic disease and to generate accurate long‐term utility assumptions for economic evaluations . Significant decrements in health state utility have been demonstrated in CRS and are comparable to other chronic disease states such as chronic obstructive pulmonary disease, diabetes mellitus, and Parkinson disease . Rudmik et al and Scangas et al performed important economic analyses utilizing health state utility values and demonstrated the cost‐effectiveness of ESS over continued medical therapy alone in appropriately selected patients .…”

Section: Discussionmentioning

confidence: 99%

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

Smith

Schlosser

Mace

et al. 2019

Int Forum Allergy Rhinol

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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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“…In practice, this was a way of considering the patient's subjective experience as an essential contributor to accurate diagnosis, health outcomes and humane care. In accordance with this philosophy, a "quality of life revolution" was observed in different areas of medicine 7 and several quality of life (QoL) questionnaires have been developed to quantify the individual and societal burden of chronic diseases. This paradigm shift also occurred for CRS.…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of the Sinonasal Outcome Test 22 (SNOT-22) in chronic rhinosinusitis

Gallo

Russo

Mozzanica

et al. 2020

Acta Otorhinolaryngol Ital

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Previous studies have highlighted that baseline Sinonasal Outcome Test 22 (SNOT-22) score affects surgical outcomes in chronic rhinosinusitis (CRS) and suggested that a SNOT-22-based approach might ameliorate patients' understanding of expectations after treatment. Our study aimed at verifying this hypothesis in an Italian CRS population. In 457 CRS patients treated with endoscopic sinus surgery after failure of maximal medical therapy, the percentage of achieving a minimal clinically important difference (MCID) and the percentage of relative improvement after surgery were calculated. Moreover, the impact of several factors on preoperative and postoperative SNOT-22 score was investigated. Symptom improvement occurred in the majority of patients and was directly proportional to baseline SNOT-22. 79,7% of patients achieved the MCID and the percentage of relative improvement was 50,1%. Psychological and social-functioning implications significantly affected SNOT-22 scores. Multiple regression analysis showed that history of previous surgery, asthma, preoperative endoscopic and SNOT-22 scores predicted the postoperative SNOT-22 score (R2 = 0,298). Submitting CRS patients to SNOT-22 prior to surgical treatments might help to inform about probable outcomes, although it is strongly influenced by individual perception. Further studies are needed to identify an effective set of subjective and objective parameters for evaluation of outcomes.

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THE 2017 13^TH ANNUAL DAVID W. KENNEDY, MD, LECTURE The evolution of outcomes in sinus surgery for chronic rhinosinusitis: past, present, and future

Abstract: This is an edited transcript from the 2017 13th Annual David W Kennedy, M.D. Lecture, presented to the American Rhinologic Society during the 63rd annual meeting.

Cited by 5 publications

References 34 publications

International consensus statement on allergy and rhinology: rhinosinusitis 2021

International consensus statement on allergy and rhinology: rhinosinusitis 2021

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

Prognostic value of the Sinonasal Outcome Test 22 (SNOT-22) in chronic rhinosinusitis

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THE 2017 13TH ANNUAL DAVID W. KENNEDY, MD, LECTURE The evolution of outcomes in sinus surgery for chronic rhinosinusitis: past, present, and future

Abstract: This is an edited transcript from the 2017 13th Annual David W Kennedy, M.D. Lecture, presented to the American Rhinologic Society during the 63rd annual meeting.

Cited by 5 publications

References 34 publications

International consensus statement on allergy and rhinology: rhinosinusitis 2021

International consensus statement on allergy and rhinology: rhinosinusitis 2021

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

Prognostic value of the Sinonasal Outcome Test 22 (SNOT-22) in chronic rhinosinusitis

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THE 2017 13^TH ANNUAL DAVID W. KENNEDY, MD, LECTURE The evolution of outcomes in sinus surgery for chronic rhinosinusitis: past, present, and future