Abstract
ObjectivesTo compare the outcome of patients with unilateral CRSsNP (U CRSsNP) and bilateral CRSsNP (B CRSsNP) undergoing FESS. Also, we evaluate the impact of SNOT-22 domains to predict their quality of life (QOL) outcomes and compare these factors with those of CRSwNP group, published in previous work.MethodsA prospective cohort study was performed in the hospital 20 August,66 patients who were presented between January 2016 and December 2017 were diagnosed with CRS according to guideline recommendations, and were beforehand refractory to initial medical therapy and elected to FESS. The Sino Nasal Outcome Test-22 (SNOT-22) was used to evaluate QOL.ResultsA higher significant improvement was observed between preoperative and postoperative SNOT-22 scores in U CRSsNP group [37.13 ± 9.307 versus 14.11 ± 8.531] and in B CRSsNP group [41.76 ± 6.949 versus 18.57 ± 8.495]. In the U CRSsNP group, patients having a preoperative SNOT-22 score higher than 20 points attained MCID in 88%. For the other group, patients having preoperative SNOT-22 score superior to 40 points achieved MCID in 66%. A multivariate logistic regression model found preoperative predictors that have impact on QOL outcomes.ConclusionsOutcomes from this study suggest that patients with U CRSsNP having a preoperative SNOT-22 scores between 10 and 19, and patients with B CRSsNP having a preoperative SNOT-22 scores between 10 and 19 or 20–29 had no chance of achieving an MCID improvement after FESS. Also, preoperative rhinologic symptoms and preoperative psychological dysfunction domains of SNOT-22 are helpful tools to predict improvement after FESS unlike the unilateral character of CRS.
Highlights
Chronic rhinosinusitis (CRS) is the most common otolaryngologic disease worldwide that has a great impact on quality of life (QOL)
Consecutive series of 76 adults diagnosed of CRSsNP were recruited
66 patients completed the study whereas 10 patients were excluded because they were lost to follow-up (15%)
Summary
Chronic rhinosinusitis (CRS) is the most common otolaryngologic disease worldwide that has a great impact on quality of life (QOL). According to Ahsan and Rudralingam, CRS with or without nasal polyposis (CRSwNP; CRSsNP) is the most common cause of unilateral sinus disease in 60.3%, while knowing that unilateral sinus disease is relatively rare and represents between 2.5% and 6% [3,4]. Functional endoscopic sinus surgery (FESS) is the treatment of choice for CRS refractory to medical therapy. Because, it allows restoring ventilation and mucociliary clearance [5,6]. It allows restoring ventilation and mucociliary clearance [5,6] Several developed instruments, such as the most recent Sino Nasal Outcome Test (SNOT-22) questionnaire, has been used for quantifying changes in symptoms and predicting extent of postoperative improvement [7].
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