Abstract
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.
Highlights
Chronic Rhinosinusitis (CRS) is a group of disorders characterized by the inflammation of mucosa of the nasal passages and paranasal sinuses lasting for duration of 12 weeks or longer [1] [2]
Chronic rhinosinusitis with or without polyps are dealt with medical therapy as first line of treatment including antibiotics, saline irrigation, topical and systemic glucocorticoids and inter leukotriene agents and surgery is reserved for those patients who fail to respond to medical treatment while allergic fungal sinusitis requires surgery as initial management [8]
The patients with age ≥ 18 years who were failed to respond to medical therapy and underwent functional endoscopic sinus surgery (FESS) for three main sub types of chronic rhinosinusitis (CRS) such as chronic rhinosinusitis without polyps, CRS with polyps and Allergic fungal sinusitis were included in the study
Summary
Chronic Rhinosinusitis (CRS) is a group of disorders characterized by the inflammation of mucosa of the nasal passages and paranasal sinuses lasting for duration of 12 weeks or longer [1] [2]. It is a broad terminology that encompasses three common subtypes which are Chronic Rhinosinusitis with polyps, CRS without polyps and Allergic Fungal Sinusitis (AFS) [2]. Chronic Rhinosinusitis gives negative impact on quality of the life (QOL), impairs daily activities of patients which leads to substantial health care expenditures. The main aim of the management of chronic rhinosinusitis is to open the airway, improvement of the smell, elimination of polyps and improvement in the quality of life of patients. Chronic rhinosinusitis with or without polyps are dealt with medical therapy as first line of treatment including antibiotics, saline irrigation, topical and systemic glucocorticoids and inter leukotriene agents and surgery is reserved for those patients who fail to respond to medical treatment while allergic fungal sinusitis requires surgery as initial management [8]. There has been found a positive and great impact on quality of life of patients who underwent FESS [8] [9]
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