Responsiveness and convergent validity of the chronic rhinosinusitis patient‐reported outcome (CRS‐PRO) measure in CRS patients undergoing endoscopic sinus surgery

2021 ◽  
Author(s):  
Katherine A. Lin ◽  
Caroline P.E. Price ◽  
Julia H. Huang ◽  
Saied Ghadersohi ◽  
David Cella ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Convergent Validity ◽  
Patient Reported Outcome ◽  
Sinus Surgery ◽  
Patient Reported

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

2021 ◽  
Vol 50 (1) ◽  
Author(s):  
Nadim Saydy ◽  
Sami P. Moubayed ◽  
Marie Bussières ◽  
Arif Janjua ◽  
Shaun Kilty ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Patient Reported Outcome ◽  
Sinus Surgery ◽  
Structured Interviews ◽  
Subjective Data ◽  
Operative Outcomes ◽  
Patient Reported ◽  
Definition Of Success ◽  
Reported Data

Abstract 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). Graphical abstract

The Use of Postoperative Antibiotics Following Endoscopic Sinus Surgery for Chronic Rhinosinusitis: A Systematic Review and Meta-analysis

2021 ◽  
pp. 194589242198914
Author(s):  
Chloe E. Swords ◽  
Jeremy J. Wong ◽  
Kara N. Stevens ◽  
Alkis J. Psaltis ◽  
Peter J. Wormald ◽  
...  
Keyword(s):  
Adverse Events ◽  
Chronic Rhinosinusitis ◽  
Outcome Measures ◽  
Endoscopic Sinus Surgery ◽  
Meta Analysis ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Sinus Surgery ◽  
Significant Difference ◽  
Patient Reported

Background Endoscopic sinus surgery is performed for medically recalcitrant chronic rhinosinusitis. There is no universally accepted strategy regarding post-operative antibiotics despite the high rates of usage worldwide. The aim of this study was to analyse patient-reported and objective outcomes behind antibiotic use following endoscopic sinus surgery. Methods A search of electronic databases was performed. Eligible randomised controlled trials (RCTs) and observational trials were included. The primary outcome was patient reported outcome measures. Secondary outcomes were local infections, endoscopy scores and adverse events. Meta-analysis was performed. Results Of 1045 publications identified, 7 were included in the qualitative synthesis and 5 RCTs were included in meta-analysis. Antibiotic regimens varied between studies in terms of antibiotic selection, timing commenced and duration of use. Meta-analysis suggested no significant difference between placebo and antibiotics in patient reported outcome measures (standardised mean difference (SMD) –0.215, 95% confidence interval (CI) –0.637 to 0.207) or endoscopic scores (SMD –2.86, 95% CI –0.846 to 0.273). There was no consistent definition in reporting of infection; therefore, this outcome cannot be comprehensively considered. No severe adverse events were attributable to antibiotics. Conclusions From the studies analysed, there is no level 1 evidence to suggest that antibiotics improved patient outcomes following sinus surgery. However, there was significant heterogeneity in outcome measures and no clear data exists regarding the effects of antibiotics on postoperative infections. The available evidence at present is not enough to make a recommendation in either direction. Further designed larger RCTs are required to investigate these questions in more detail.

scholarly journals Responsiveness and Convergent Validity of a New Patient-Reported Outcome Measure for Chronic Rhinosinusitis (CRS-PRO)

2020 ◽  
Vol 8 (7) ◽  
pp. 2351-2359.e2
Author(s):  
Saied Ghadersohi ◽  
Caroline P.E. Price ◽  
Jennifer L. Beaumont ◽  
Robert C. Kern ◽  
David B. Conley ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Convergent Validity ◽  
Outcome Measure ◽  
Patient Reported Outcome ◽  
Patient Reported Outcome Measure ◽  
Patient Reported

scholarly journals Effects of functional endoscopic sinus surgery on chronic rhinosinusitis resistant to medication

2014 ◽  
Vol 128 (11) ◽  
pp. 976-980 ◽  
Author(s):  
H Li ◽  
X Zhang ◽  
Y Song ◽  
T Wang ◽  
G Tan
Keyword(s):  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Conservative Therapy ◽  
Therapy Group ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Therapeutic Effects ◽  
Post Surgery ◽  
Surgery Group ◽  
Patient Reported

AbstractObjective:To evaluate the therapeutic effects of functional endoscopic sinus surgery in patients with chronic rhinosinusitis who were unresponsive to medical treatment.Methods:A total of 232 patients were divided into 2 groups: a functional endoscopic sinus surgery group (n = 162) and a conservative therapy group (n = 70). Efficacy was assessed in terms of Lund–Kennedy endoscopy scores and Sino-Nasal Outcome Test 20 symptom scores.Results:In the functional endoscopic sinus surgery group, Lund–Kennedy and Sino-Nasal Outcome Test 20 scores were significantly lower at 3, 6 and 12 months post-surgery compared with baseline scores. In the conservative therapy group, both sets of scores were significantly lower at 3 months, but not at 12 months. In this latter group, the Lund–Kennedy scores decreased only slightly and the Sino-Nasal Outcome Test 20 scores significantly decreased at six months compared with initial scores, indicating disparity between the subjective and objective measures. Patient-reported symptom improvement was better in the functional endoscopic sinus surgery group than in the medication group at 12 months (p < 0.001).Conclusion:These findings suggest that functional endoscopic sinus surgery has better efficacy over a longer period compared with conservative therapy.

Systematic Review of Patient-Reported Outcomes after Revision Endoscopic Sinus Surgery

2017 ◽  
Vol 31 (4) ◽  
pp. 248-255 ◽  
Author(s):  
Shashi Prasad ◽  
Eric Fong ◽  
Eng H. Ooi
Keyword(s):  
Systematic Review ◽  
Endoscopic Sinus Surgery ◽  
Meta Analysis ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Sinus Surgery ◽  
Patient Response ◽  
Postnasal Drip ◽  
Patient Reported ◽  
The Impact

Background Revision endoscopic sinus surgery (RESS) may be required for partially controlled or uncontrolled chronic rhinosinusitis. Studies that reported technical success, e.g., sinus ostia patency after RESS, do not address whether the patient's symptoms and quality of life (QOL) improve after surgery. However, patient-reported outcome measures (PROM) are useful to assess the impact of sinus surgery on a patient's symptoms and QOL. Objective This systematic review was undertaken to evaluate the impact of RESS on PROMs. Methods Medical literature databases were searched for studies in English. References from retrieved articles and relevant reviews were examined for additional studies. Those studies that reported QOL outcome tools in patients who underwent RESS and with a minimum follow-up of 6 months were included. Results A search of the sources yielded 1856 citations. There were 72 articles after abstract review and exclusion, identified for full-text review, with 12 studies (which contained data from 1308 patients) that met the inclusion criteria for this systematic review. There were four “good” and eight “fair” studies. Three studies used the Rhinosinusitis Disability Index and Chronic Sinusitis Survey in tandem; two each used the 20-item Sino-Nasal Outcome Test and the 22-item Sino-Nasal Outcome Test; the remaining studies used either the Adelaide Disease Severity Score, Patient Response Score (PRS), Rhinosinusitis Symptom Inventory, Rhinosinusitis Outcome Measure 31, or the Chinese version of the University of Pennsylvania Smell Identification Test. All studies used validated PROMs apart from the study that used PRS. Studies consistently reported improvement in the five key symptoms of nasal obstruction, rhinorrhea, postnasal drip, facial pain, and anosmia, although improvement in halitosis, fever, dental pain, and cough were modest. Conclusion Several PROMs demonstrated that RESS improves patient's QOL symptoms. Future studies that examine QOL should use a consistent PROM to allow a meta-analysis.

Desmopressin effects on bleeding during functional endoscopic sinus surgery on patients with chronic rhinosinusitis

2021 ◽  
pp. 103024
Author(s):  
Fatemeh Hajimohamadi ◽  
Jawad Hosseini ◽  
Farrokh Heidari ◽  
Sepideh Alvandi ◽  
Shahin Bastaninezhad ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery
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