Year in review: 2021 <i>IFAR</i> article summary

Rowan, Nicholas R.; Beswick, Daniel M.

doi:10.1002/alr.23045

Cited by 1 publication

(1 citation statement)

References 57 publications

(85 reference statements)

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“…The first line treatment for CRS consists of appropriate medical therapy, which is founded in nasal saline irrigations, topical nasal steroids, and/or a judicious course of oral steroids and oral antibiotics. 23 Nevertheless, up to 20% of individuals remain unresponsive to medical management and turn to surgical intervention; more than 500 000 endoscopic sinus surgeries (ESS) are performed annually. 24 Although exposure to PM has been associated with an increased risk of developing CRS, it is unknown whether pollution levels at the time of surgery negatively impact post-operative outcomes.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Acute Peri-operative Particulate Matter Exposure on Endoscopic Sinus Surgery Outcomes: A Preliminary Multi-site Investigation

Tullis,

Mace,

Hagedorn

et al. 2024

Am J Rhinol�Allergy

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Background Environmental exposures have been postulated to play an important role in the pathophysiology of chronic rhinosinusitis (CRS). Particulate matter (PM) is one of the most widely studied ambient air pollutants, but its peri-operative impact on CRS is unknown. Objective To determine the effect of acute, peri-operative PM exposure on outcomes after endoscopic sinus surgery (ESS). Methods Participants with CRS who self-selected ESS were prospectively enrolled. The 22-item SinoNasal Outcome Test (SNOT-22) and Medical Outcomes Study Questionnaire Short-Form 6-D (SF-6D) health utility values scores were recorded. Using residence zip codes, a secondary analysis of patient exposure to PM <2.5 μm and <10 μm (PM2.5 and PM10, respectively) was performed for the month of surgery utilizing data from Environmental Protection Agency air quality monitors. Spearman's correlation coefficients (ρ), 95% confidence intervals (CIs), and effect estimates (β) were used to determine the magnitudes of association. Simple, multivariate regression analysis was also completed. Results One hundred and seven patients from four geographically unique institutions across the US were enrolled with a follow-up of 6 months. Patients with higher peri-operative PM2.5 exposure had less improvement in their SNOT-22 scores after ESS compared to those with less exposure using both univariate analysis (ρ = 0.26, 95% CI: 0.08, 0.43; P = .01) and after covariate adjustment with multivariate analysis ( B = 1.06, 95% CI: 0.001, 2.14, P = .05). Similar associations were not found with SF-6D outcomes or with PM10 as an exposure of interest. No significant correlations were found between peri-operative PM levels and Lund-Kennedy endoscopy scores post-operatively. Conclusion Preliminary data from this pilot study reveal that PM exposure at the time of ESS may negatively associate with post-operative improvement in sinonasal quality-of-life. Larger, population-based studies with more standardized PM exposure windows are needed to confirm the clinical significance of the present findings.

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Section: Introductionmentioning

confidence: 99%