Chronic Rhinosinusitis (CRS) is a group of disorders characterized by the inflammation of mucosa of the nasal passages and paranasal sinuses. It includes chronic rhinosinusitis with polyps, CRS without polyps and Allergic Fungal Sinusitis (AFS). This debilitating disease causes negative impact on quality of life (QOL) of patients. Functional endoscopic sinus surgery (FESS) is the mainstay of surgical treatment for patients and improves QOL of patients. This subjective assessment of QOL can be measured by disease specific questionnaires. SNOT-22 questionnaire is widely used and validated questionnaire for this purpose. Prospective study was done on 54 patients. Data were collected using SNOT-22 questionnaire and filled in pre-operative period then in post-operative follow-up visits on 1st, 3rd, 6th and 12th months. Paired sample t-test was used to compare pre-operative and post-operative SNOT scores and multivariate generalized linear model was used to estimate regression parameters for SNOT scores in CRS with polyp and AFS in comparison of CRS without polyps. Out of 54 patients, 59.3% were males, mean age was 35.98, 29.6% were in CRS without polyp group, 44.4% and 25.9% were in CRS with polyps and AFS group. Recurrence occurred in 7.4%, revision surgery required in 3.7% while 22.2% had history of asthma. Paired sample t-test showed statistical significant reduction in post-operative SNOT scores. Linear model results showed SNOT scores in CRS with polyp group was significantly reduced. Thus FESS provides significant improvement in QOL of patients in chronic rhinosinusitis.
References
[1]
Vaid, L., Khanna, S. and Singh, P. (2007) Impact of Nasal Polyps on Quality of Life of Chronic Sinusitis Patients. Indian Journal of Otolaryngology and Head & Neck Surgery, 59, 136-141. https://doi.org/10.1007/s12070-007-0040-3
[2]
Chan, Y. and Kuhn, F.A. (2009) An Update on the Classifications, Diagnosis and Treatment of Rhinosinusitis. Current Opinion in Otolaryngology & Head and Neck Surgery, 17, 204-208. https://doi.org/10.1097/MOO.0b013e32832ac393
[3]
Voegels, R.L. and de Melo Padua, F.G. (2005) Expression of Interleukins in Patients with Nasal Polyposis. Otolaryngology—Head and Neck Surgery, 132, 613-619. https://doi.org/10.1016/j.otohns.2005.01.014
[4]
Fokkens, W., Lund, V. and Mullol, J. (2007) European Paper on Rhinosinusitis and Nasal Polyps Groups. Rhinology. Supplement, No. 20, 1-136.
[5]
Meltzer, E. and Hamilos, D. (2011) Rhinosinusitis and Management for the Clinician: A Synopsis of Recent Concensus Guidelines. Mayo Clinic Proceedings, 86, 427-443. https://doi.org/10.4065/mcp.2010.0392
[6]
Bhattacharyya, N. (2004) Symptom Outcomes after Endoscopic Sinus Surgery for Chronic Rhinosinusitis. Archives of Otolaryngology—Head and Neck Surgery, 130, 329-333. https://doi.org/10.1001/archotol.130.3.329
[7]
Alobid, I., Bernal, S.M., et al. (2008) Chronic Rhinosinusitis and Nasal Polyps: The Role of Genric and Specific Questionnaires on Assessing Its Impact on Patients’s Quality of Life. Allergy, 63, 1267-1279. https://doi.org/10.1111/j.1398-9995.2008.01828.x
[8]
Ehnhage, et al. (2011) One Year after Endoscopic Sinus Surgery in Polyposis: Asthma, Olfaction and Quality of Life Outcomes. Otolaryngology—Head and Neck Surgery, 146, 834-841. https://doi.org/10.1177/0194599811435638
[9]
Bezerra, T., et al. (2012) Assessment of Quality of Life after Endoscopic Sinus Surgery for Chronic Rhinosinusitis. Brazilian Journal of Otorhinolaryngology, 78, 96-102. https://doi.org/10.1590/S1808-86942012000200015
[10]
Marambaia, P.P., Lima, M.G., Santos, K.P., et al. (2013) Evaluation of Quality of Life of Patients with Chronic Rhinosinusitis by Means of the SNOT-22 Questionnaire. Brazilian Journal of Otorhinolaryngology, 79, 54-58. https://doi.org/10.5935/1808-8694.20130010
[11]
Hopkins, C., Gillett, S., et al. (2009) Psychometric Validity of the 22-Item Sinonasal Outcome Test. Clinical Otolaryngology, 34, 447-454. https://doi.org/10.1111/j.1749-4486.2009.01995.x
[12]
Brett Cherry, W. and Li, J.T. (2008) Chronic Rhinosinusitis in Adult. The American Journal of Medicine, 121, 185-189. https://doi.org/10.1016/j.amjmed.2007.09.022
[13]
Halawi, A.M., Smith, S.S. and Chandra, R.K. (2013) Chronic Rhinosinusitis: Epidemiology and Cost. Allergy & Asthma Proceedings, 34, 328-334. https://doi.org/10.2500/aap.2013.34.3675
[14]
Damm, M., Quante, G., Jungehuelsing, M. and Stennert, E. (2002) Impact of Functional Endoscopic Sinus Surgery on Symptoms and Quality of Life in Chronic Rhinosinusitis. Laryngoscope, 112, 310-315. https://doi.org/10.1097/00005537-200202000-00020
[15]
Stewart, M.G. and Smith, T.L. (2005) Objective versus Subjective Outcomes Assessment in Rhinology. American Journal of Rhinology, 19, 529-535.
[16]
De Conde, A.S., Mace, J.C., Bodner, T., et al. (2014) SNOT-22 Quality of Life Domains Differentially Predict Treatment Modality Selection in Chronic Rhinosinusitis. International Forum of Allergy & Rhinology, 4, 972-979. https://doi.org/10.1002/alr.21408
[17]
Nikakhlagh, S., Bakhshi, A. and Noroozi, S. (2015) Evaluation of Quality of Life of Patients with Chronic Rhinosinusitis before and after Endoscopic Sinus Surgery. Biomedical and Pharmacology Journal, 8, 73-77.
[18]
Nair, S., Dutta, A., Rajagopalan, R. and Nambiar, S. (2011) Endoscopic Sinus Surgery in Chronic Rhinosinusitis and Nasal Polyposis: A Comparative Study. Indian Journal of Otolaryngology and Head & Neck Surgery, 63, 50-55. https://doi.org/10.1007/s12070-011-0119-8
[19]
Lam, K., Hirsch, A.G. and Tan, B.K. (2014) The Association of Premorbid Diseases with Chronic Rhinosinusitis with and without Polyps. Current Opinion in Otolaryngology & Head and Neck Surgery, 22, 231-241. https://doi.org/10.1097/MOO.0000000000000052
[20]
Hopkins, C., Browne, J.P., Slack, R., Lund, V., Topham, J., Reeves, B., et al. (2006) The National Comparative Audit of Surgery for Nasal Polyposis and Chronic Rhinosinusitis. Clinical Otolaryngology, 31, 390-398. https://doi.org/10.1111/j.1749-4486.2006.01275.x
[21]
Mascarenhas, J.G., Fonseca, V.M.G., Chen, V.G., et al. (2013) Long Term Outcomes of Endoscopic Sinus Surgery for Chronic Rhinosinusitis with and without Polyps. Brazilian Journal of Otorhinolaryngology, 79, 306-311. https://doi.org/10.5935/1808-8694.20130055
[22]
Champagne, J.P., Antisdel, J.L., Woodard, T.D. and Kountakis, S.E. (2010) Epidemiologic Factors Affect Surgical Outcomes in Allergic Fungal Sinusitis. Laryngoscope, 120, 2322-2324. https://doi.org/10.1002/lary.21127
[23]
Masterson, L., Ergo, F.M., Bewick, J., et al. (2016) Quality of Life Outcomes after Sinus Surgery in Allergic Fungal Rhinosinusitis versus Nonfungal Chronic Rhinosinusitis. American Journal of Rhinology & Allergy, 30, 30-35. https://doi.org/10.2500/ajra.2016.30.4280
[24]
Mishra, D.K., Bhatta, R. and Verma, L.R. (2010) Quality of Life after Functional Endoscopic Sinus Surgery. Nepalese Journal of ENT Head and Neck Surgery, 1, 6-8.
