Olfactory improvement after endoscopic sinus surgery.

Purpose Of Review: Olfactory dysfunction is a common complaint in patients with chronic rhinosinusitis (CRS). The purpose of this article is to review the current evidence on the impact of endoscopic sinus surgery (ESS) on CRS-related olfactory dysfunction.

Recent Findings: The recent literature suggests that olfactory outcomes after ESS are challenging to predict.

Interrater reliability of endoscopic parameters following sinus surgery.

Objectives/hypothesis: To determine the interrater reliability of a set of postoperative endoscopic scoring parameters in patients with chronic rhinosinusitis who have undergone endoscopic sinus surgery (ESS).

Study Design: Prospective cohort with retrospective review.

Methods: One hundred twenty video-endoscopic evaluations in 20 subjects recorded at 14, 30, and 45 days after ESS were scored in real time by the clinical investigators who performed the endoscopies and recorded the videos and retrospectively by an independent panel of four sinus surgeons who were blinded to all information.

Endoscopic sinus surgery checklist.

Over 250,000 endoscopic sinus surgeries are performed yearly in the United States alone. Although overall complication rates are low, errors can lead to significant morbidity due to the close proximity of the sinuses to the orbit and skull base and the resultant potential for blindness, cerebrospinal fluid leak, and catastrophic bleeding. Surgical checklists are endorsed by the World Health Organization and have been incorporated into most U.

Concurrent septoplasty during endoscopic sinus surgery for chronic rhinosinusitis: does it confound outcomes assessment?

Objectives/hypothesis: To determine if chronic rhinosinusitis (CRS)-specific health-related quality-of-life (HRQoL) outcomes are affected by concurrent septoplasty performed during endoscopic sinus surgery (ESS) for medically refractory CRS.

Study Design: Prospective, multicenter cohort study.

Methods: A total of 221 patients with medically refractory CRS without nasal polyposis who elected primary ESS were included in this study.

Health state utility values in patients undergoing endoscopic sinus surgery.

Objectives/hypothesis: The primary study goal was to measure health state utility values in patients with chronic rhinosinusitis (CRS) before and after undergoing endoscopic sinus surgery (ESS). A secondary goal was to assess the meaning of these values by comparing them with other chronic disease processes and currently available medical or surgical treatments.

Study Design: Prospective, observational cohort study.

The impact of osteitis on disease severity measures and quality of life outcomes in chronic rhinosinusitis.

Background: The significance of osteitis in the management of recalcitrant chronic rhinosinusitis (CRS) has yet to be clearly understood and clinical outcomes data for these patients is lacking. Osteitis has been characterized by inflammatory infiltrate, osteoneogenesis, and bony sclerosis with remodeling. In this study we sought to determine if osteitis negatively impacts quality-of-life (QOL) or clinical outcomes following endoscopic sinus surgery (ESS).

Smoking and endoscopic sinus surgery: does smoking volume contribute to clinical outcome.

Background: The effect of tobacco smoking on chronic rhinosinusitis (CRS) is not yet well-delineated. The purpose of this investigation was to evaluate the overall effect of smoking on postoperative outcomes (endoscopic score and health-related quality-of-life [HRQoL]) after endoscopic sinus surgery (ESS) for CRS and to determine if volume of daily smoking impacts outcomes.

Methods: A total of 784 patients with CRS were prospectively enrolled between January 2001 and April 2009 after electing ESS from 1 of 3 academic tertiary care centers.

Endoscopic sinus surgery reduces antibiotic utilization in rhinosinusitis.

Background: Antibiotics are a mainstay of treatment for chronic rhinosinusitis (CRS) and recurrent acute rhinosinusitis(RARS). Although quality-of-life outcomes following endoscopic sinus surgery (ESS) have been studied, the change in antibiotic utilization following ESS is less wellknown.

Objective: We aimed to determine the effect of ESS on antibiotic utilization in CRS and RARS.

Role of depression in outcomes of endoscopic sinus surgery.

Objective: To prospectively measure the prevalence and effect of symptomatic depression on chronic rhinosinusitis (CRS) patients' quality of life (QOL), disease severity, and outcomes of endoscopic sinus surgery (ESS).

Study Design: Prospective cohort study.

Setting: Academic, tertiary care center.

Quality of life in patients with chronic rhinosinusitis.

Health-related quality of life (HRQoL) is a domain of quality-of-life assessment that is influenced by the individual's perception of his or her health status. Measurement of HRQoL can enable physicians to understand how an illness interferes with a patient's day-to-day life, improve patient-physician communication, and optimize clinical outcomes. Chronic rhinosinusitis (CRS) is one of the most common chronic diseases, affecting 14-16% of the adult US population.

Quality-of-life outcomes after endoscopic sinus surgery: how long is long enough?

Objective: To determine the time interval during which quality-of-life (QOL) outcomes stabilize after endoscopic sinus surgery (ESS).

Study Design: Multi-institutional, longitudinal cohort.

Setting: Tertiary rhinology centers.

Ethmoid histopathology does not predict olfactory outcomes after endoscopic sinus surgery.

Background: Histological inflammation correlates with the degree of baseline olfactory dysfunction in patients with chronic rhinosinusitis (CRS); however, factors associated with improvement in olfactory status after endoscopic sinus surgery (ESS) remain elusive. Our purpose was to compare histopathological findings in CRS patients with olfactory loss and evaluate whether inflammatory markers can predict long-term olfactory improvement after ESS.

Methods: Adult (> or = 18 years) patients with CRS were prospectively enrolled after electing ESS due to failed medical management.

Revision frontal sinusotomy using stepwise balloon dilation and powered instrumentation.

Objectives/hypothesis: To report a novel approach toward revision frontal sinusotomy using a technique of balloon dilation followed by the use of powered instrumentation.

Study Design: Case report.

Methods: The frontal sinus outflow tract location was first confirmed with image guidance and then dilated with a balloon to address the soft tissue stenosis.

Surgery for chronic rhinosinusitis may improve sleep and sexual function.

Objectives/hypothesis: This study was designed to evaluate the impact of surgery on the sexual function and sleep function of patients with chronic rhinosinusitis (CRS).

Study Design: A retrospective review of a cohort of prospectively enrolled patients with chronic rhinosinusitis who have undergone endoscopic sinus surgery.

Methods: Each patient completed the Rhinosinusitis Disability Index (RSDI) prior to surgery and at least nine months following endoscopic sinus surgery, and the preoperative and postoperative scores for the questions related to sleep and sexual activity were evaluated.

Outcomes of sinus surgery in ambulatory patients with immune dysfunction.

Background: Previous outcomes studies of patients with chronic rhinosinusitis (CRS) have mostly excluded subjects with immunodeficiency or autoimmune disease. Although expert opinion suggests these patients are often refractory to therapy, outcomes after endoscopic sinus surgery (ESS) are not well delineated. We evaluated improvement in objective and quality of life (QoL) measures after ESS in adult patients treated in the ambulatory setting with immune dysfunction including immunodeficiency and autoimmune diseases.

Quality of life outcomes after functional endoscopic sinus surgery.

Most patients with chronic rhinosinusitis seek medical treatment when the burden of symptoms negatively impacts their quality of life. The degree to which quality of life improves after sinus surgery is a critical indicator of surgical success. This article reviews quality of life outcomes after functional endoscopic sinus surgery, including relevant clinical factors, weaknesses in the current literature, and future research directions.

Correlations between endoscopy score and quality of life changes after sinus surgery.

Objective: To assess whether change in endoscopy score correlates with change in health-related quality of life (HRQOL) following endoscopic sinus surgery for chronic rhinosinusitis.

Design: Prospective open cohort.

Setting: Tertiary rhinology clinic.

Outcomes after middle turbinate resection: revisiting a controversial topic.

Objectives/hypothesis: To evaluate differences in endoscopy exam, olfactory function, and quality-of-life (QOL) status after endoscopic sinus surgery (ESS) for patients with and without bilateral middle turbinate (BMT) resection.

Study Design: Open, prospective, multi-institutional cohort.

Methods: Subjects completing enrollment interviews, computed tomography (CT), and endoscopy exam were asked to provide pre- and postoperative responses to the Smell Identification Test (SIT), Rhinosinusitis Disability Index (RSDI), Chronic Sinusitis Survey (CSS), and the Medical Outcomes Study Short Form-36 Health Survey (SF-36).

Fracture of bony lamellae within the frontal recess after balloon catheter dilatation.

Background: The precise manner in which balloon catheter dilatation (BCD) alters the dimensions of the frontal recess and frontal sinus outflow tract is not well characterized. The purpose of this investigation was to determine whether BCD within the frontal recess is associated with reproducible patterns of fracture in bony lamellae, to characterize changes between pre- and postintervention measurements of the frontal sinus outflow tract, and to compare the degree of change seen with endoscopic Draf I dissection.

Methods: Eight cadaver heads underwent pre- and postintervention endoscopic visualization and computed tomography (CT) of the frontal recess and frontal sinus outflow tract.

Impact of mucosal eosinophilia and nasal polyposis on quality-of-life outcomes after sinus surgery.

Objective: Assess whether the presence of mucosal eosinophilia correlates with surgical outcomes in patients with chronic rhinosinusitis.

Study Design: Prospective cohort.

Setting: Tertiary medical center.

Determinants of outcomes of sinus surgery: a multi-institutional prospective cohort study.

Objectives: 1) To measure the proportion of patients with chronic rhinosinusitis (CRS) who experience clinically significant improvement after endoscopic sinus surgery (ESS) in a prospective, multi-institutional fashion. 2) To identify preoperative characteristics that predict clinically significant improvement in quality of life (QOL) after ESS.

Study Design: Prospective, multi-institutional cohort study.

Outcomes of surgery for inferior turbinate hypertrophy.

Purpose Of Review: There are numerous available surgical techniques in use to address inferior turbinate hypertrophy. The current review will discuss the most widely used and recently studied techniques for turbinate surgery and highlight recent publications discussing clinical outcomes.

Recent Findings: Microdebrider-assisted inferior turbinoplasty and radiofrequency ablation are mucosal sparing techniques that have been recently studied in direct comparison.

Relationship between clinical measures and histopathologic findings in chronic rhinosinusitis.

Objective: Describe detailed histopathologic findings from a cohort of patients with chronic rhinosinusitis and evaluate whether histologic measures correlate with baseline clinical factors.

Study Design: Cross-sectional study with planned data collection.

Setting: Tertiary medical center.