Effects of Smoking on Quality of Life Following Sinus Surgery: 4-Year Follow-Up

Objectives/Hypothesis: The purpose of this study is to report on long-term outcomes in a prospective study comparing the quality-of-life outcomes in smokers and nonsmokers undergoing functional endoscopic sinus surgery. Study Design: Prospective clinical trial. Methods: A total of 235 patients were prospectively enrolled at a single tertiary academic center. Preoperative Sino-Nasal Outcomes Test (SNOT)-20 scores and comprehensive demographic and smoking data were obtained. Preoperative SNOT-20 scores were compared to postoperative SNOT-20 scores. Results: Long-term follow-up results were available in 111/185 nonsmokers (60%) and 26/50 smokers (52%). Nonsmokers had a mean preoperative SNOT-20 score of 26.2, a short-term follow-up score of 10.1 (mean, 3.1 months) and a long-term follow-up score of 11.4 (mean, 44.2 months). Smokers had a mean preoperative SNOT-20 score of 27.8, a short-term follow-up score of 5.7 (mean, 3.1 months) and a long-term follow-up score of 8.3 (mean, 40.3 months). The mean improvement in SNOT-20 scores for smokers was significantly greater than nonsmokers in short-term follow-up (P = .044), however, no significant difference in improvement was seen between smokers and nonsmokers at long-term follow-up. Conclusions: Both smokers and nonsmokers continue to maintain a highly significant improvement in SNOT-20 scores following endoscopic sinus surgery at long-term follow-up. Although smoking remains a well-documented cause of medical morbidity, smokers maintained an improvement in quality of life after long-term follow-up from endoscopic sinus surgery in this prospective study.