Patient quality of life improvements with and without computer assistance in sinus surgery: Outcomes study

Background: Chronic rhinosinusitis affects millions of North Americans and has been increasing annually since 1991. This study aimed to evaluate the effectiveness of functional endoscopic sinus surgery (FESS) done with the use of computer assistance (CASS) and without the use of computer assistance on patient quality of life. As of this writing, there is no published study that measures the difference in patient quality of life with and without image guidance in endoscopic sinus surgery. Methods: A nonrandomized prospective study was performed on 95 patients. A 31-item quality of life (Rhinosinusitis Outcome Measures Form [RSOM-31]) questionnaire was administered to patients prior to surgery and 6 months following surgery during a 3-year enrollment period. Patients assessed both rhinologic and nonrhinologic symptoms using a statistically validated scoring system. Statistical analysis was performed using both equal and unequal variance sample t-tests when appropriate. Results: Statistically significant improvement in mean score analysis between preoperative and postoperative results for all symptom subgroups was reported when the entire study population was included. When the improvement in quality of life was compared between the CASS and FESS surgical groups, the CASS group demonstrated an overall greater improvement in quality of life. Conclusion: Quality of life restrictions in patients with chronic rhinosinusitis were greatest in the areas of nasal symptoms and sleep deprivation, which were significantly improved by endoscopic sinus surgery. Although the long-term effect of CASS as measured by patient quality of life remains relatively unknown, there appears to be a significant trend indicating greater quality of life improvement in the short term over non-computer-assisted FESS techniques.