TY - JOUR
T1 - Improvements in psychological dysfunction after endoscopic sinus surgery for patients with chronic rhinosinusitis
AU - Levy, Joshua M.
AU - Mace, Jess C.
AU - DeConde, Adam S.
AU - Steele, Toby
AU - Smith, Timothy L.
PY - 2016/9/1
Y1 - 2016/9/1
N2 - Background: Psychological dysfunction is highly prevalent among patients with chronic rhinosinusitis (CRS). Previous study has identified various measures of anxiety and depression as predictors of quality-of-life outcomes following endoscopic sinus surgery (ESS). Psychological dysfunction scores, as measured by the 22-item Sino-Nasal Outcome Test (SNOT-22), have been found to influence treatment decision making in CRS. This study aims to further elucidate improvement in discrete psychological symptoms following ESS for CRS. Methods: Adult patients with medically recalcitrant CRS electing to undergo ESS were prospectively enrolled into a multi-institutional, observational cohort. Psychological-related symptom severity and postoperative outcomes were assessed using psychological domain items of the SNOT-22, including subgroup analysis of patients with and without comorbid depression. Results: A total of 374 participants met inclusion criteria and were followed postoperatively for a mean ± standard deviation (SD) of 14.6 ± 5.0 months. Total mean psychological domain scores improved from 15.9 ± 8.2 to 8.5 ± 8.4 (p < 0.001). Significant relative mean improvements were reported in “waking up tired” (23%; p < 0.001), “fatigue” (25%; p < 0.001), “reduced productivity” (28%; p < 0.001), “reduced concentration” (27%; p < 0.001), “ frustrated/restless/irritable” (27%; p < 0.001), “sad” (15%; p < 0.001), and “embarrassed” (8%; p < 0.001) scores. A total of 64% to 66% of participants reported improvement in “reduced productivity,” “waking up tired,” “fatigue,” and “frustrated/restless/irritable,” compared to 46% and 38% reporting improvement in “sad” and “embarrassed,” respectively. Conclusion: Patients with CRS report significant improvement in common mental health–related symptoms following ESS. Despite these improvements, some degree of persistent postoperative psychological dysfunction was reported. Further study is necessary to determine which factors are associated with persistent psychological dysfunction after ESS in order to optimize treatment outcomes.
AB - Background: Psychological dysfunction is highly prevalent among patients with chronic rhinosinusitis (CRS). Previous study has identified various measures of anxiety and depression as predictors of quality-of-life outcomes following endoscopic sinus surgery (ESS). Psychological dysfunction scores, as measured by the 22-item Sino-Nasal Outcome Test (SNOT-22), have been found to influence treatment decision making in CRS. This study aims to further elucidate improvement in discrete psychological symptoms following ESS for CRS. Methods: Adult patients with medically recalcitrant CRS electing to undergo ESS were prospectively enrolled into a multi-institutional, observational cohort. Psychological-related symptom severity and postoperative outcomes were assessed using psychological domain items of the SNOT-22, including subgroup analysis of patients with and without comorbid depression. Results: A total of 374 participants met inclusion criteria and were followed postoperatively for a mean ± standard deviation (SD) of 14.6 ± 5.0 months. Total mean psychological domain scores improved from 15.9 ± 8.2 to 8.5 ± 8.4 (p < 0.001). Significant relative mean improvements were reported in “waking up tired” (23%; p < 0.001), “fatigue” (25%; p < 0.001), “reduced productivity” (28%; p < 0.001), “reduced concentration” (27%; p < 0.001), “ frustrated/restless/irritable” (27%; p < 0.001), “sad” (15%; p < 0.001), and “embarrassed” (8%; p < 0.001) scores. A total of 64% to 66% of participants reported improvement in “reduced productivity,” “waking up tired,” “fatigue,” and “frustrated/restless/irritable,” compared to 46% and 38% reporting improvement in “sad” and “embarrassed,” respectively. Conclusion: Patients with CRS report significant improvement in common mental health–related symptoms following ESS. Despite these improvements, some degree of persistent postoperative psychological dysfunction was reported. Further study is necessary to determine which factors are associated with persistent psychological dysfunction after ESS in order to optimize treatment outcomes.
KW - chronic rhinosinusitis
KW - endoscopic sinus surgery
KW - patient outcome assessment
KW - psychology
KW - quality of life
KW - sinusitis
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U2 - 10.1002/alr.21776
DO - 10.1002/alr.21776
M3 - Article
C2 - 27080574
AN - SCOPUS:84985916497
VL - 6
SP - 906
EP - 913
JO - International Forum of Allergy and Rhinology
JF - International Forum of Allergy and Rhinology
SN - 2042-6976
IS - 9
ER -