Long-term outcome analysis of endoscopic sinus surgery for chronic sinusitis

Jonathan Young, Saul Frenkiel, Marc A. Tewfik, Debbie A. Mouadeb

Research output: Contribution to journalArticle

39 Scopus citations

Abstract

Background: The purpose of this study was to determine long-term subjective outcome of endoscopic sinus surgery (ESS) for chronic sinusitis (CS) and to evaluate prognostic indicators for surgical treatment failure. Methods: This is a prospective study of patients who underwent ESS for CS. Symptom assessment was performed using a visual analog scale at a pretreatment interview and then at regular intervals post-ESSfor up to a 3-year period. The indicators for symptom scoring were nasal obstruction, facial pain, postnasal drip, anterior discharge, and anosmia/hyposmia. Results: Data analysis indicates that ESS improves symptom scoring early on, but the effects begin to dissipate over time. Anosmia/ hyposmia is the most severe symptom overall for all patient subgroups and recurs to a greater degree 3 years postoperatively in Samter's Triad sufferers (p = 0.006), asthmatic patients (p = 0.002), and those with a worse CT scan at presentation (p = 0.04). In addition, Triad sufferers who complain of nasal obstruction and anterior nasal discharge have a significant recurrence of their symptoms postoperatively (p = 0.04 and 0.001, respectively). Conclusion: Individuals must be warned that ESS may not be a long-term solution for CS because of its chronic nature. Patients are relieved of their symptoms initially; however, these tend to recur over a 3-year period. Samter's Triad is the strongest determinant of long-term treatment failure. Asthma also is a determinant of treatment failure, which lends credence to the notion of combined airway disease. Allergy was not a strong determinant of treatment failure in our study.

Original languageEnglish (US)
Pages (from-to)743-747
Number of pages5
JournalAmerican Journal of Rhinology
Volume21
Issue number6
DOIs
StatePublished - Nov 1 2007
Externally publishedYes

Keywords

  • AERD
  • Allergy
  • Anosmia
  • Aspirin-exacerbated respiratory disease
  • Asthma
  • Chronic sinusitis
  • Endoscopic sinus surgery
  • Outcome analysis
  • Samter's Triad
  • Visual analog scale

ASJC Scopus subject areas

  • Otorhinolaryngology

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