Symptom-based presentation of chronic rhinosinusitis and symptom-specific outcomes after endoscopic sinus surgery

被引:102
作者
Soler, Zachary M. [1 ]
Mace, Jess [1 ]
Smith, Timothy L. [1 ]
机构
[1] Oregon Hlth & Sci Univ, Dept Otolaryngol Head & Neck Surg, Div Rhinol & Sinus Surg, Oregon Sinus Ctr, Portland, OR 97239 USA
来源
AMERICAN JOURNAL OF RHINOLOGY | 2008年 / 22卷 / 03期
关键词
chronic rhinosinusitis; endoscopic sinus surgery; facial pain; headache; outcomes; quality-of-life; sinusitis; symptoms; visual analog scales;
D O I
10.2500/ajr.2008.22.3172
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Background: Very few studies have comprehensively examined specific symptom outcomes of endoscopic sinus surgery (ESS). The purpose of this study was to define the individual symptoms of a cohort of patients with medically refractory chronic rhinosinusitis (CRS) using visual analog scale (VAS) scores as well as report symptom-based outcomes after ESS. Methods: Patients with medically refractory CRS presenting for surgical management were asked to evaluate baseline symptoms using 10-cm VAS measures. Participants were asked to rank their most debilitating symptoms in descending order. VAS scores were assessed postoperatively at 3, 6, 12, and 18 months. The Kruskal-Wallis test was used to assess improvement in mean symptom VAS scores at each of the postoperative time points. Results: Nasal congestion elicited the highest preoperative VAS score with an average of 6.5, followed by fatigue (6.0), headache (5.8), decreased sense of smell (5.5), nasal drainage (5.5), and facial pain-pressure (5.5). Headache was the most commonly reported disabling condition. Follow-up data after ESS was available for 207 patients. Average VAS scores for 6 of 7 symptoms showed significant and sustainable postoperative improvement at 3, 6, 12, and 18 months after surgery (p < 0.001). Improvement in VAS score for headache was not statistically significant (p > 0.700). Conclusion: This study indicates that patients with medically refractory CRS presenting for surgery complain of associated symptoms with great frequency. ESS results in both statistically and clinically significant improvements in six of seven symptoms. Headache, which was the most highly ranked disabling symptom, did not show significant improvement from baseline.
引用
收藏
页码:297 / 301
页数:5
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