Rhinosinusitis Disability Index Research Articles

Chemokine CCL19 and Its Receptors CCR7 and CCRL1 in Chronic Rhinosinusitis.

CCL19 has been shown to predict disease severity in COVID-19 and treatment response in rheumatoid arthritis. CCL19 can exert both pro- and anti-inflammatory effects and is elevated in chronic rhinosinusitis (CRS). However, its role in CRS remains unknown. This study sought to determine the transcriptional changes in CCL19, its receptors, and associated cytokines and their association with disease severity in CRS. A clinical database of control subjects and patients with CRS was examined. Lund-Kennedy, Lund-Mackay, Sinonasal Outcomes Test 22 (SNOT-22), and rhinosinusitis disability index (RSDI) scores were collected at enrollment. mRNA was extracted from sinonasal tissues and subjected to multiplex gene expression analysis. Gene transcript differences between patients with CRS and controls were compared and correlated with disease severity metrics. Immunohistochemical analyses of CCL19, CCR7, and CCRL1 were conducted to compare differences in protein expression between cohorts. A subgroup analysis was performed to compare transcriptional and protein expression difference between patients with (CRSwNP) and without (CRSsNP) nasal polyps and controls. Thirty-eight subjects (control group, n=7; CRS group, n=31) were included in this study. CCRL1 (p=0.0093) and CCR7 (p=0.017) levels were significantly elevated in CRS compared to those in controls. CCL19 (p=0.038) and CCR7 (p=0.0097) levels were elevated in CRSwNP and CCRL1 was elevated in CRSsNP (p=0.0004). CCR7 expression was significantly elevated in sinonasal epithelial cells in CRSwNP (p=0.04). CCL19 expression was positively correlated with TNFA expression (p<0.0002). CCL19 and CCR7 expression was positively correlated with SNOT-22 and RSDI scores (p<0.05). CCL19 and CCR7 may modulate TNF-α-driven pro-inflammatory signaling and contribute to increased disease severity in CRS. Mechanistic studies are required to further elucidate the role of CCRL1 in CRS.

Which is Better in Predicting CT Scores in Patients with Chronic Rhinosinusitis after Medical treatment-Baseline Rhinosinusitis Disability Index (RSDI) or Endoscopic Score?

Which is Better in Predicting CT Scores in Patients with Chronic Rhinosinusitis after Medical treatment-Baseline Rhinosinusitis Disability Index (RSDI) or Endoscopic Score?

Evaluation of Effectiveness of Sinus Surgery in Chronic Rhinosinusitis Patients using Sinonasal Outcome Index-22, modified Lund Mackay Score and Rhinosinusitis Disability Index

Functional endoscopic sinus surgery (FESS) is done in patients with chronic rhinosinusitis (CRS) not responding to medical therapy. This study aims to evaluate the subjective, objective and overall quality of life improvement in CRS patients following FESS surgery. Sinonasal outcome index-22, modified Lund-Mackay score and Rhinosinusitis Disability Index were used to evaluate subjective, objective and overall quality of life in patients with CRS. The questionnaires were asked before the surgery and three months after surgery. A total of 110 patients were enrolled in the study. All three types of evaluation showed improvement following FESS surgery. FESS in CRS patients refractory to medical management caused significant improvement in symptom intensity, endoscopic score and overall quality of life.

Effect of Adding Physiotherapy Program to the Conservative Medical Therapy on Quality of Life and Pain in Chronic Rhinosinusitis Patients.

: To assess the effectiveness of combining physiotherapy techniques with conservative medical treatment in chronic rhinosinusitis (CRS) patients. : Sixty-eight volunteers with CRS were randomly assigned. Group A received only traditional medical treatment, whereas group B received a physiotherapy program that included pulsed ultrasound therapy, sinus manual drainage techniques, and self-sinus massage technique in addition to traditional medical treatment. Interventions were applied 3 sessions a week for 4 weeks. The rhinosinusitis disability index (RSDI) served as the main outcome indicator for assessing the quality of life, and the secondary outcome measure was the pressure pain threshold (PPT) using a pressure algometer. : Wilcoxon signed rank test revealed a significant reduction (p<0.001) in total RSDI values from 71.08±1.13 pretest to 47.14±1.15 posttest for group A, while it decreased from 70.64±1.20 pretreatment to 31.76±1.04 posttreatment for group B; furthermore, Mann-Whitney U-test revealed a significant difference (p<0.001) in total RSDI values between both groups when comparing the change of the pre-post data values, it was 23.94±0.95 for group A and 38.88±0.67 for group B. The independent t-test revealed a highly statistically significant increase (p<0.001) in the PPT values in the experimental group compared to the control group. : The physiotherapy program which included pulsed ultrasound therapy, sinus manual drainage technique, and self-sinus massage technique in conjunction with conventional medical treatment was more beneficial for enhancing the quality of life and PPT than traditional medical treatment alone in CRS patients.

The Prevalence and Impact of Allergic Rhinitis on Academic Performance and Quality of Life Among Medical Students in Saudi Arabia.

Allergic Rhinitis (AR) has a negative impact on both patients and society. Our study aims to assess the impact of allergic rhinitis on the academic performance and quality of life of medical students in Saudi Arabia. A cross-sectional survey targeted medical students in Saudi Arabia; a total of 851 students were included. The survey included questions on sociodemographic characteristics, academic year and GPA, Score for Allergic Rhinitis (SFAR), and Rhino-sinusitis Disability Index (RSDI). We found that about 340 students (39.9%) had AR. The RSDI for students with AR was 34.9 ‡ 28.8, significantly higher than those with no AR (17.0 + 23.6),p<0.001. The relationship between AR and students* GPAs showed that those who had not experienced AR significantly had comparatively good PAs and above. In contrast, those who had experienced AR had poor GPAs (p<0.001). Similarly, students with AR had significantly missed classes more than those who had not experienced AR (p<0.001). The study showed that Allergic rhinitis negatively impacted Medical Students' academic performance and quality of life. It impacts wakefulness, and sleeping patterns can have a negative impact on academic performance.

A clinical study to evaluate the efficacy of Ayurvedic interventions in the management of Pinasa (chronic rhinosinusitis)

Abstract BACKGROUND: The disease “Pinasa” is a chronic nasal disease affecting the nasal canal and paranasal sinuses and can be correlated with chronic rhinosinusitis in contemporary science. Given the literary indication, the present work evaluated the clinical efficacy and safety of Chitrak Haritaki Avaleha (CHA) and Shadbindu Taila (SBT) in the management of chronic rhinosinusitis. MATERIALS AND METHODS: This study was conducted as an open-label, multi-centre, prospective clinical study and executed at two institutes of the Central Council for Research in Ayurvedic Sciences at New Delhi and Patiala. In total, 120 participants aged between 18 and 60 years, suffering from chronic rhinosinusitis, were enrolled in the study. The interventions were Chitraka Haritaki (CHA) (06 g) in the form of Avaleha twice a day after food and Nasya with Shadbindu Taila (SBT) in the dose of 06 Bindu (drops) for 7 days for three consecutive cycles with intervals of 7 days. The participants were assessed every 14 days. The total duration of treatment was 42 days, followed by a follow-up of 28 days. The primary outcome was assessed as the change in the Rhino Sinusitis Disability Index (RSDI) score, and the secondary outcomes were change in the Sino Nasal Outcome Score (SNOT) 20 score and change in Lund–Mackay scores of CT scan para nasal sinus. RESULTS: A total of 120 participants were enrolled in the study (60 in each center). Among them, data of 115 participants who completed the study were used for analysis. The mean RSDI and SNOT 20 scores were observed to undergo gradual reduction from baseline to the 14th, 28th, and 42nd days. A significant improvement in the mean total RSDI score and SNOT 20 (P &lt; 0.001) was observed after the 42nd day of treatment and also at the end of the 70th day in comparison to baseline (# Compared using paired sample t-test). CONCLUSION: The Ayurvedic formulations, SBT Nasya and CHA administration, are safe and significantly reduce the symptoms such as Mucopurulent drainage (anterior, posterior, or both), nasal obstruction (congestion), facial pain-pressure-fullness, and decreased sense of smell.

Impact of chronic rhinosinusitis on patients' quality of life in the western region, Saudi Arabia 2022

Background: Rhinosinusitis is distinguished by the simultaneous inflammation of the sinonasal mucosa. Chronic rhinosinusitis (CRS) has been demonstrated to have a negative influence on people's quality of life (QoL), as measured by a variety of standardized outcome instruments. We conducted this study to explore the impact of CRS on patients' QoL in the Western Region, Saudi Arabia. Subjects and Methods: This was an observational cross-sectional study carried out among population of the Western Region in Saudi Arabia in 2022. All males and females above the age of 18 years old were invited for participation. The data were collected by using a self-administered semi-structured questionnaire which was distributed via social media. SPSS version 23.0 was used for data analysis. Results: A total number of participants were 468. Most of them were females (76.9%), with males representing 23.1%. More than half of the respondents were from age between 18 and 28 years. In addition, our results revealed that during the past 8 weeks, a 1–2 week period was the most commonly reported duration of symptoms. Furthermore, the most commonly affected domain of rhinosinusitis disability index was the physical domain, followed by the emotional domain and functional domain. Conclusion: Our results suggested that CRS reduced QoL among people from the Western Region, Saudi Arabia. Further evaluation and research are needed to minimize the disability caused by CRS.

Prevalence, determinants of chronic rhinosinusitis and its impact on quality of life among students in Karachi, Pakistan.

Chronic rhinosinusitis (CRS) is a common public health issue among students. A total of 300 undergraduate students wereselected through multistage cluster sampling from three public-sector universities. Sino-nasal Outcome Test (SNOT-22) and Rhinosinusitis Disability Index (RSDI) were used for determining the quality of life. Chi-square and independent t-test were used. About 46% and 54% (p =0.001) of social science and health science students were suffering from CRS, respectively. Around 7% and 9% of CRS patients had poor quality of life according to SNOT-22 and RSDI, respectively (p =0.042 and p =0.032, respectively). Quality of life wasaffected in all domains of SNOT-22 and RSDI.

Relationship between health literacy and disease-specific quality of life in patients with sinonasal disease.

Patients with limited health literacy tend to have worse medical outcomes, often due to decreased medication compliance or reduced capacity to self-manage disease. Health literacy can be assessed using validated tools such as the Brief health literacy screening tool (BRIEF). This study theorizes that lower health literacy is associated with worse sinonasal disease quality of life (QOL). A cohort of 187 patients at our clinic were routinely screened for health literacy and rhinosinusitis disability index (RSDI) scores. Health literacy is categorized into "Limited," "Marginal," and "Adequate." The higher the RSDI, the worse the patient's QOL. Patients were stratified into "New" and "Established" groups. Their demographic data and sinonasal disease-specific QOL were recorded. Statistical analysis was performed to assess the relationship between health literacy and Sinonasal Disease-specific QOL. The cohort mean age was 50 years, and 56% were females. In "New" patients, "Limited" health literacy was associated with an increase in RSDI scores (p<0.0001). This study demonstrates that patients with limited health literacy have a worse sinonasal disease-specific QOL. Therefore, rhinologists must be aware of this discrepancy and tailor their care appropriately to help patients with limited health literacy. This article is protected by copyright. All rights reserved.

An Observational Study of Quality of Life in Patients of Allergic Rhinitis in a Tertiary Health Care Centre of South Gujarat.

Allergic rhinitis (AR) refers to an IgE-mediated inflammation following exposure to allergen. Often deemed as a minor inconvenience rather than a disease, AR impairs the QOL. Medical treatment has a beneficial effect. To evaluate the QOL in patients of AR. Patients of AR with ≥ 18 years age, receiving treatment in our department are included. Pre and Post treatment VAS (Visual Analogue Scale) and RSDI (Rhinosinusitis Disability Index) are compared to know the effect of disease and treatment on QOL. The patients of PAR (Persistent Allergic Rhinitis) had a greater impact on QOL. In PAR, a combination of INCS (Intranasal Corticosteroids) + oral antihistaminics result in significant reduction in VAS & RSDI scores. In IAR (Intermittent Allergic Rhinitis), Oral antihistaminics monotherapy was most effective in reducing itching while Oral antihistaminics + 1 week of intranasal decongestant was most effective in reducing sneezing, running nose and nasal blockage. Oral antihistaminics + LTRA (Leukotriene Receptor Antagonist) was most effective in reducing physical RSDI score. Oral antihistaminics + 1 week of intranasal decongestantwas most effective in reducing functional and emotional RSDI score. Functional RSDI scores had improved much higher than emotional and physical scores. All these observations were statistically significant. AR does affect the QOL while pharmacotherapy helps in improving the overall QOL. Oral antihistaminic alone or in combination with local decongestant/LTRA in IAR cases while INCS + oral antihistaminic in PAR cases are significantly effective in controlling symptom scores and QOL.

Association of Sinonasal Computed Tomography Scores to Patient-Reported Outcome Measures: A Systematic Review and Meta-analysis.

To perform a systematic review of proposed sinus computed tomography (CT) scoring systems and determine their association with patient-reported outcome measures (PROMs). PubMed, CINAHL, Scopus, and Cochrane Library. A systematic search was conducted following the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses) for studies describing CT scores and PROMs in patients with chronic rhinosinusitis. A total of 144 studies were included. Out of 20,741 patients, 53.6% were male and 55.5% had nasal polyposis. A meta-analysis of correlations revealed a moderate correlation between Lund-McKay (LM) and the 22-item Sinonasal Outcome Test (SNOT-22; r = 0.434, P < .001) and a weaker correlation between LM and the 20-item Sinonasal Outcome Test (SNOT-20; r = 0.257, P = .039). Meta-regression also revealed a weak association between LM and SNOT-20 (n = 25 studies) but no significant associations between Zinreich score and SNOT-22 or LM scores and PROMs, including SNOT-22 (n = 94 studies), Rhinosinusitis Disability Index (n = 25), nasal obstruction visual analog scale (n = 15), Chronic Sinusitis Survey (n = 12), Total Nasal Symptom Score (n = 4), Total Symptom Score (n = 3), and 12-Item Short Form Health Survey (n = 3). There is essentially little association between radiologic grade and PROMs. CT grading systems with improved clinical utility are needed.

Predictors of olfactory improvement after endoscopic sinus surgery in chronic rhinosinusitis with nasal polyps.

This study aimed to determine the predictors of olfactory improvement after endoscopic sinus surgery among patients with chronic rhinosinusitis with nasal polyps. This prospective cohort study included patients admitted to a university hospital between 2006 and 2012. Assessment using odour identification testing, a sinonasal symptom questionnaire, the Rhinosinusitis Disability Index and mucus biomarker levels was performed at various time points. Correlation of variables with identification score differences at six post-operative time points and at baseline was performed, followed by multiple linear regression to determine significant predictors at each of the six post-operative time points. Baseline absence of acute sinusitis, elevated serpin F2 and anterior rhinorrhoea predict early olfactory improvement, whereas baseline allergic rhinitis predicts late olfactory improvement. Baseline odour identification score was the strongest predictor across all time points. Patients with chronic rhinosinusitis and nasal polyps with worse disease or baseline olfactory function may benefit more from endoscopic sinus surgery in terms of olfactory improvement.

Mental health burden of empty nose syndrome compared to chronic rhinosinusitis and chronic rhinitis.

Empty nose syndrome (ENS) is characterized by the paradoxical perception of nasal obstruction despite patent sinonasal anatomy after surgery. We investigated the relationship between ENS, and anxiety, depression, obsessive-compulsive disorder, and somatic symptom disorder (SSD) compared to individuals with chronic rhinitis (CR) and chronic rhinosinusitis (CRS). This cross-sectional survey study compared ENS and CR and CRS patients. A total of 116 patients participated: 58 ENS patients from digital support groups, and 58 CRS and CR patients from tertiary rhinology clinics. Study participants completed four validated surveys: (1) Empty Nose Syndrome 6-Item Questionnaire, (2) Rhinosinusitis Disability Index (RSDI), (3) Obsessive Compulsive Inventory - Revised (OCI-R), and (4) PRIME MD Patient Health Questionnaire (PHQ). ENS patients exhibited a mean RSDI of 78.6, 95% confidence interval [CI] 72.8-84.5, compared to 25.2, 95% CI 18.6-31.8 for CRS/CR patients (p<0.0001). This difference was seen across all subdomains. Using the PHQ, 53% of ENS patients met diagnostic thresholds for SSD compared to 14% of CRS patients (p<0.0001). In relation to obsessive compulsive disorder (OCD), 18.37% of ENS patients compared to 8.62% of CRS/CR patients scored above the diagnostic threshold (>21) on the OCI-R questionnaire (p=0.159). ENS patients had diminished sinonasal quality of life and a higher prevalence of comorbid anxiety and depression, compared to CR and CRS. ENS patients were more likely to exceed thresholds for OCD and SSD compared to controls. Future studies are needed to assess the role of SSD in ENS to help optimize treatment for these complex patients.

MANAGEMENT OF CHRONIC SINUSITIS THROUGH ALTERNATE RECHANA AND SNEHANA NASYA - REPORT FROM A PILOT STUDY

Chronic sinusitis is the chronic inflammatory condition affecting the paranasal sinuses. It may be correlated to Dushta pratisyāya in Ayurveda, which is a Kapha predominant disease affecting jatṟuṛdhva bhāgā which needs teekshna virecana nasya for its management. Vāgbhaṭācārya opines that except for vātika rogas, nasya should be done as ekāhāntara (alternate day) i.e., with a gap of one day in between. But according to Cakṟadatta commentary, ekāhāntara nasya is to be done with virecana nasya and snehana nasya on alternate days. For virecana nasya, Tuḷasi patṟa svarasa (Ocimum sanctum Linn.) and for snehana nasya, Aṇutaila were selected. A patient aged 43 years diagnosed with adult rhinosinusitis diagnostic criteria was taken for the study and was given ekāhāntara nasya with Tuḷasi patṟa svarasa and Aṇutaila for 7 days. During follow up period Pathyākṣadhātṟyādi kaṣāya was given for 15 days. Samyak nasya lakṣaṇa and Event evaluation scales were assessed on each day of nasya and Scale for scoring of symptoms, Rhinosinusitis Disability Index and Visual Analogue Scale were assessed before trial, after trial and after follow up. After the course of treatment 100% improvement was found in the Scale for scoring of symptoms, Rhinosinusitis Disability Index and Visual Analogue Scale. Keywords: Case report, Ekāhāntara (alternate day) nasya, Tuḷasipatṟasvarasa, Aṇutaila, Chronic sinusitis

Pain Catastrophizing and Quality of Life in Adults With Chronic Rhinosinusitis.

Psychological comorbidity is common in patients with chronic rhinosinusitis (CRS) and is correlated with decreased overall and disease-specific quality of life (QoL). Prior research reported that anxiety and depression, as measured by the hospital anxiety and depression scale (HADS), are associated with worse CRS-specific QoL, as assessed via the Rhinosinusitis Disability Index (RSDI). Furthermore, patients prone to anxiety/depression may display an exaggerated response to real or anticipated discomfort; the pain catastrophizing scale (PCS) is a validated instrument designed to measure this phenomenon. This study is intended to explore the role of pain catastrophizing in relation to anxiety, depression, and disease-specific QoL in patients with facial pain attributed to CRS. Prospective cohort study. Diagnosis of presumed CRS was based upon current American Academy of Otolaryngology - Head & Neck Surgery (AAO-HNS) guidelines; all participants reported facial pain as a component of their CRS symptomatology. RSDI, HADS, and PCS questionnaires were administered upon presentation prior to intervention, and objective measurements of sinonasal inflammation were obtained via nasal endoscopy and computed tomography (CT). Seventy-five patients were enrolled in the study. Significant positive correlations were found between PCS and HADS, total RSDI, and RSDI emotional sub-scores (P < .05). The incidence of objective evidence of disease, as measured via nasal endoscopy and CT, was not significantly different in catastrophizing patients. Pain catastrophizing correlates with anxiety/depression and worse disease-specific QoL in patients meeting symptomatic criteria for CRS. Otolaryngologists should be aware that catastrophic thinking can intensify a patient's perception of sinonasal symptoms, and clinicians may consider management of psychological comorbidity to optimize rhinologic outcomes. 4 Laryngoscope, 131:1939-1945, 2021.

Relationship between pain-related comorbidities and quality of life in patients with symptoms of chronic rhinosinusitis

IntroductionFacial pain is a common manifestation of sinonasal disease but may be due to a variety of other conditions. Misattribution of pain to chronic rhinosinusitis may result in worse quality of life in populations both with and without objective evidence of sinonasal disease. The purpose of this study was to determine if there is an association between pain-related comorbidities and worse chronic rhinosinusitis specific quality of life in patients with and without objective evidence of sinonasal inflammation. MethodsRetrospective cohort study of 299 patients meeting diagnostic criteria for sinusitis evaluated at a tertiary academic medical center from 2017 to 2018. Objective evidence was measured using the Lund-Kennedy and Lund-MacKay scoring systems; for the purposes of this study a score >3 on either scale was considered indicative of disease. Quality of life was determined by the rhinosinusitis disability index. ResultsA total of 191 patients were included in the study, with an average age of 52.7. (SD=15.3). The average Lund-Kennedy and Lund-MacKay scores were 4.7 and 8.3, respectively. The average rhinosinusitis disability index was 32.1. When stratified by the presence of pain-related comorbidities, there was no significant difference in Lund-Kennedy (p = 0.203), Lund-MacKay (p = 0.101), or rhinosinusitis disability index (p = 0.421). ConclusionAlthough prior studies have suggested a correlation between the presence of pain-related comorbidities and worse chronic rhinosinusitis specific quality of life, this relationship was not evident within the current cohort of patients. The relationship between pain and sinusitis specific quality of life is likely complex and requires further research to fully elucidate.

The prevalence of chronic sinusitis symptoms among inflammatory bowel disease patients at tertiary hospital in Riyadh

Background: The etiologies of both chronic rhinosinusitis (CRS) and inflammatory bowel disease (IBD) are not well known. Both are inflammatory diseases that are triggered by genetic and environmental factors. Existing literature lacks the evaluation of the overlap between these clinical entities. Herein, we attempt to determine the prevalence of CRS symptoms among the patients with IBD at King Khalid University Hospital. Methodology: This text presents a cross-sectional study on patients with confirmed diagnoses based on colonoscopy and histological findings. Patients were evaluated using the chronic sinusitis survey (CSS) and the rhinosinusitis disability index (RSDI). Other variables evaluated in this study include age, gender, chronic illnesses, duration of the IBD, smoking, medications, and family history. Results: Eighty-two IBD patients were enrolled in the study, and of these patients, 61 have Crohn's disease (CD) and 21 have ulcerative colitis (UC). There was no statistically significant difference in the presence of sinonasal symptoms between patients with CD and UC: 11.47% and 9.52%, respectively. CSS score was nonsignificantly higher among CD patients: 10.79 compared to 6.15 for UC patients, P = 0.125. In addition, the RSDI score was higher among CD patients: 13.11 compared to 5.14 in UC patients. However, this difference is not significant, P = 0.069. Conclusion: The prevalence of CRS symptoms among IBD patients is comparable to the general population. It was nonsignificantly less prevalent in UC patients in comparison to CD patients.

The effect of pratidina (daily) practice and ekahantara (alternate) practice of nasya with anutaila in chronic sinusitis – A comparative clinical trial

Nasya is the panchakarma to eliminate morbid doshas in head and neck. Vagbhatacharya opines that except for Vatika clinical conditions Nasya should be done for 7a days but as ekahanthara (alternate) that is with a gap of one day in between. As no previous studies were available on the efficacy and safety of ekahantara nasya, a comparative clinical study was conducted with anutaila in chronic sinusitis. 20 participants were divided by convenience sampling into group A (pratidina nasya) and group B (ekahantara nasya). The assessment was done by Scoring of symptoms, Haematological evaluation, Rhino sinusitis disability index, Event evaluation scale and Nasya samyak lakshana. Significant reduction in symptoms score was seen in both group A (psamyak yoga score was 82% in group A while in group B it was 95%. Asmyak yoga score in group A was 18% and 5% in group B and the difference was statistically significant (pekahantara practice of nasya with Anutaila was more safe and effective compared to pratidina practice of nasya in chronic sinusitis. Keywords: Ekahantara nasya, Pratidina nasya, Chronic sinusitis, Anutaila

Pre-treatment clinical study of rhinosinusitis impact on the quality of life among patients having both external nasal deformity and deviated nasal septum

&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Sino-nasal disease often gives an experience of impacting quality of life significantly, more so among chronic cases. Hence a self-perceived disease specific impact viz rhinosinusitis disability index (RSDI) which is a validated reliable measure of quality of life is being studied.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A prospective study conducted on patients, attending department of ENT on out and or in-patient basis who are diagnosed to have rhinosinusitis with external nasal deformity and deviated nasal septum (DNS) were selected on simple random basis for this study between July 2018 to November 2019. This study group subjected for answering standard questionnaire of RSDI proforma before treatment. Data statistically analyzed using IBM SPSS version 22.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the statistically calculated ‘n' (40) patients of this study, 23 were male (57.5%) and 17 were female (42.5%) patients of the age between 15-45 years. In our study, majority of patients (n=23) had simple type DNS (57.5%), followed by obstructive type 37.5% (n=15) and impacted type 5% (n=2) and majority of patients showed type I (50%) external nasal deformity followed by type V (25%). In our study, 11 patients were diagnosed with acute rhinosinusitis, 15 patients with chronic rhinosinusitis without nasal polyps (CRSsNP) and 14 patients with chronic rhinosinusitis with nasal polyps (CRSwNP). The physical, functional and emotional domains showed no statistical significance with respect to external nasal deformity and DNS. However, disease factor had statistically significant impact (p&amp;lt;0.05) on the quality of life among rhinosinusitis patients with mean scores of 13.7, 19.42, and 10.80.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In rhinosinusitis patients, the disease affects the quality of life in terms of physical, functional and emotional domains, but not by the external nasal deformity and or DNS associated.&lt;/p&gt;

Predictors of Surgical Outcomes After Functional Endoscopic Sinus Surgery in Chronic Rhinosinusitis.

Chronic rhinosinusitis has an incidence of 15% in India. Functional endoscopic sinus surgery (FESS), in case of failed medical management, is the current treatment protocol in Chronic rhinosinusitis. This study aims to assess the outcome of FESS as measured by subjective quality of life indices; Rhinosinusitis Disability Index (RSDI) and Sinonasal Outcome Test (SNOT-22. It also assesses the predictive factors which influence the outcome after FESS. The study was conducted among 100 patients with Chronic Rhinosinusitis who underwent FESS, after failure of medical management. Immunocompromised or pregnant patients and patients with history of previous sinus surgery or malignancy were excluded from the study. The evaluation was done using Lund Kennedy endoscopy scores, Lund Mackay CT scan scores and RSDI and SNOT-22 questionnaires (baseline and 3months post-op). Statistical analysis was done using Wilcoxon signed-rank test, Kruskall Wallis test, Mann Whitney test and Chi-square test. p < 0.05 was considered significant. RSDI and SNOTT 22 scores showed a mean change 34.78 and 33.04 respectively after FESS, with a p value of < 0.001, which was highly significant. The pre-operative factors which predicted a poor quality of life after FESS were smoking, Allergy and Asthma. Higher pre-operative Endoscopic and CT scores resulted in an improved quality of life after FESS. Gender, concurrent septoplasty and sinonasal polyposis did not influence the quality of life outcomes after FESS. The study determines the quality of life after FESS and also analyses the factors responsible for poor prognosis after functional endoscopic sinus surgery. This study will enable the ENT surgeons to adequately counsel the patients before surgery.