What is the optimal outcome after endoscopic sinus surgery in the treatment of chronic rhinosinusitis? A consultation of Canadian experts

被引：15

作者：

Saydy, Nadim ^{[1
]}

Moubayed, Sami P. ^{[2
]}

Bussieres, Marie ^{[3
]}

Janjua, Arif ^{[4
]}

Kilty, Shaun ^{[5
]}

Lavigne, Francois ^{[1
]}

Monteiro, Eric ^{[6
]}

Nayan, Smriti ^{[7
]}

Piche, Marilou ^{[8
]}

Smith, Kristine ^{[9
]}

Sommer, Doron ^{[7
]}

Sowerby, Leigh ^{[10
]}

Tewfik, Marc A. ^{[11
]}

Witterick, Ian J.

Wright, Erin ^{[12
]}

Desrosiers, Martin ^{[1
]}

机构：

[1] Univ Montreal, Ctr Hosp Univ Montreal, Div Otolaryngol Head & Neck Surg, Montreal, PQ, Canada

[2] Univ Montreal, Maisonneuve Rosemont Hosp, Div Otolaryngol Head & Neck Surg, Montreal, PQ, Canada

[3] Univ Sherbrooke, Div Otolaryngol Head & Neck Surg, Ctr Hosp Univ Sherbrooke, Hotel Dieu Hosp, Quebec City, PQ, Canada

[4] Univ British Columbia, Vancouver Gen Hosp, Div Otolaryngol Head & Neck Surg, Vancouver, BC, Canada

[5] Univ Ottawa, Ottawa Hosp, Div Otolaryngol Head & Neck Surg, Ottawa, ON, Canada

[6] Univ Toronto, Mt Sinai Hosp, Div Otolaryngol Head & Neck Surg, Toronto, ON, Canada

[7] McMaster Univ, Cambridge Mem Hosp, Div Otolaryngol Head & Neck Surg, Hamilton, ON, Canada

[8] Laval Univ, Div Otolaryngol Head & Neck Surg, Hop St Sacrement, Quebec City, PQ, Canada

[9] Univ Manitoba, Winnipeg Hlth Sci Ctr, Div Otolaryngol Head & Neck Surg, Winnipeg, MB, Canada

[10] Western Univ, St Josephs Hosp, Div Otolaryngol Head & Neck Surg, London, ON, Canada

[11] McGill Univ, Jewish Gen Hosp, Div Otolaryngol Head & Neck Surg, Montreal, PQ, Canada

[12] Univ Alberta, Div Otolaryngol Head & Neck Surg, Walter C MacKenzie Hlth Sci Ctr, Edmonton, AB, Canada

来源：

JOURNAL OF OTOLARYNGOLOGY-HEAD & NECK SURGERY | 2021年 / 50卷 / 01期

关键词：

Chronic rhinosinusitis; Endoscopic sinus surgery; Patient-centered care; Short title; Impressions of endoscopic sinus surgery; QUALITY-OF-LIFE; SLEEP; DYSFUNCTION; DEPRESSION; IMPROVEMENT; SYMPTOMS; CRITERIA; SUCCESS; IMPACT;

D O I：

10.1186/s40463-021-00519-9

中图分类号：

R76 [耳鼻咽喉科学];

学科分类号：

100213 ;

摘要：

Objectives: Many experts feel that in the absence of well-defined goals for success, they have an easier time identifying failure. As success ought to not be defined only by absence of failure, we aimed to define optimal outcomes for endoscopic sinus surgery (ESS) in chronic rhinosinusitis (CRS) by obtaining expert surgeon perspectives. Methods: A total of 12 surgeons participated in this targeted consultation. Face to face semi-structured interviews were performed with expert surgeons in the field of CRS and ESS. General impressions and personal definitions of acceptable operative success and optimal operative outcomes were compiled and summarized. Results: According to an expert survey, patients' main objectives are an improvement in their chief complain, a general improvement in quality of life (QoL), and a better overall symptomatic control. The most important aspects of endoscopy for defining a successful intervention were an adequate mucus circulation, a healthy mucosa, minimal edema, and patency of all explored cavities or ostia. In the assessment of surgical outcomes, it was determined that both objective and patient reported data must be carefully examined, with more attention given to subjective outcomes. Conclusions: According to data gathered from a Canadian expert consultation, a definition of success must be based on both subjective data and nasal endoscopy. We propose to define an acceptable outcome as either a subjective improvement of at least the minimal clinically improvement difference of a validated patient reported outcome questionnaire, along with a satisfactory endoscopic result (1) or a complete subjective resolution with a sub-optimal endoscopy (2).

引用

页数：10

共 41 条

[1] Endoscopic sinus surgery improves cognitive dysfunction in patients with chronic rhinosinusitis [J].