Document Detail


Influence of polyps on outcomes after endoscopic sinus surgery.
MedLine Citation:
PMID:  17690616     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine clinical and comparative outcomes for endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS) with polyposis. METHODS: Two cohorts of adult patients with refractory CRS with and without nasal polyps were prospectively studied before and after ESS (minimum follow-up, 12 months) with the Rhinosinusitis Symptom Inventory (RSI). For the non-polyp and polyp cohorts, RSI symptom domains and medical resource utilization were compared in the preoperative and postoperative states. Corresponding effect sizes were computed and compared between cohorts to determine the effect of polyps on prognosis after ESS. RESULTS: A total of 165 non-polyp and 86 polyp patients were enrolled. Polyps were more common in female patients (2:1, P = .025); age (mean, 42.9 years) and follow-up (18.5 months) were similar between groups. Lund scores were significantly higher for polyp patients (13.7, SD 4.8) vs. non-polyp patients (8.1, SD 5.3, P < .001). At baseline, polyp patients reported lower symptom scores for facial, oropharyngeal, and systemic RSI symptom domains (all P < .012); nasal and total symptom domains were similar between groups. Both non-polyp and polyp groups obtained significant symptomatic benefit from ESS with effect sizes for RSI symptom domain improvements ranging from 0.89 to 1.38 and 0.43 to 1.19, respectively (all P < .001). There were no significant differences between groups in symptomatic improvement, excepting oropharyngeal symptoms (better improvement in non-polyp group, P = .024). Non-polyp patients decreased medical resource consumption more significantly than did polyp patients. CONCLUSIONS: Both non-polyp and polyp patients derive similar clinically significant symptomatic improvement after ESS. These similarities suggest that polyp patients do not necessarily have a poorer symptomatic outcome after ESS.
Authors:
Neil Bhattacharyya
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Laryngoscope     Volume:  117     ISSN:  0023-852X     ISO Abbreviation:  Laryngoscope     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-10-24     Completed Date:  2007-11-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607378     Medline TA:  Laryngoscope     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1834-8     Citation Subset:  IM    
Affiliation:
Division of Otolaryngology, Brigham and Women's Hospital, Boston, Massachusetts, USA. neiloy@massmed.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-Bacterial Agents / therapeutic use
Anti-Inflammatory Agents / therapeutic use
Bacterial Infections / complications,  drug therapy,  epidemiology
Cohort Studies
Drug Therapy / statistics & numerical data
Endoscopy / methods*
Female
Follow-Up Studies
Histamine H1 Antagonists / therapeutic use
Humans
Male
Nasal Polyps / drug therapy,  microbiology,  surgery*
Postoperative Care
Preoperative Care
Prognosis
Prospective Studies
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Anti-Inflammatory Agents; 0/Histamine H1 Antagonists

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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