Quality of Life after Functional Endoscopic Sinus Surgery in Patients with Chronic Rhinosinusitis at Tertiary Care Hospital
Background: Chronic rhinosinusitis (CRS) is a pathogenic disease of infection commonly affected the ear, nose and throat. Chronic Rhinosinusitis (CRS) has a serious negatively impact over quality of life of patients. Quality of life, nature of job and environmental conditions are the primary reasons of spread of rhinosinusitis. Most of the symptoms of CRS are not life threatening but generally these leads to poor quality of life by affecting the efficiency of individuals.
Methods: This prospective study was conducted in the department of ENT in tertiary care hospital among the 50 patients with clinical presentation, endoscopy examination and CT-scan changes of chronic rhinosinusitis (CRS) without a polyp. The history of the patients were taken and then the different ENT examinations were done like endoscopic examination of the nose and CT-scan imaging. All the surgeries like uncinectomy, middle meatal antrostomy, anterior and posterior ethmoidectomy, or opening of the sphenoid sinus were performed under general anesthesia with orotracheal intubation and hypotensive technique. All the patients were regularly given the postoperative antibiotic and nasal steroid treatments and reviewed regularly. Sinonasal Assessment Questionnaire - 11 (SNAQ-11) were used for the collection of data because this questionnaire contains 11 questions covering most of the symptoms of sinonasal diseases. Results: ‘Total 50 patients were included in this study among them 32 (64%) were male and 18 (36%) were females. All the patients was between 18-60 years among them 16 (32%) were the age group 25-35 years, followed by age group 35-45 years 14 (28%). The most common preoperative complaint of the patients was nasal obstruction (100%) patients, followed by nasal congestion (96%), facial pain (94%), running nose (90%), anterior nasal discharge (76%), and least complaint was sneezing (28%) and earache (28%).
Conclusion: The study concludes, this study shows the significant outcome of improvement in the quality of life of patients in all the three subgroups of chronic rhinosinusitis which can be assessed by using SNOT-11 questionnaire. The Functional endoscopic sinus surgery performed in patients with chronic rhinosinusitis has statistically significant with the association of improvement in the QoL after twenty 24 month follow up. There is paucity of data so more studies are required to the scientific evidence gathered on the effectiveness of surgery offered to our population, as seen in studies performed in other countries.
2. RudmikL, SmithTL. Quality of life in patients with chronic rhinosinusitis. Curr Allergy Asthma Rep. 11(3) :247-52 (2011).
3. Gliklich RE, Metson R. The health impact of chronic sinusitis in patients seeking otolaryngologic care. Otolaryngol Head Neck Surg. 1995;113:104-109
4. Benninger MS, Ferguson BJ, Hadley JA, Hamilos DL, Jacobs M, Kennedy DW, et al. Adult chronic rhinosinusitis: definitions, diagnosis, epidemiology, and pathophysiology. Otolaryngol Head Neck Surg. 2003;129(3 Suppl):S1-32.
5. Osguthorpe JD. Adult rhinosinusitis: diagnosis and management. Am FamPhysician. 2001;63(1):69-76.
6. Fokkens W, Lund V, Mullol J. EP3OS 2007: European position paper on rhinosinusitis and nasal polyps 2007. A summary for otorhinolaryngologists. Rhinology. 2007;45(2):97-101.
7. Voegels RL, de Melo Padua FG. Expression of interleukins in patients with nasal polyposis. Otolaryngol Head Neck Surg. 2005;132(4):613-9.
8. Nikakhlagh, S., Bakhshi, A. and Noroozi, S. (2015) Evaluation of Quality of Life of Patients with Chronic Rhinosinusitis before and after Endoscopic Sinus Surgery. Biomedical and Pharmacology Journal, 8, 73-77
9. Harvey RJ, Snidvongs K, Kalish LH, et al. Corticosteroid nasal irrigations are more effective than simple sprays in a randomized double-blinded placebo-controlled trial for chronic rhinosinusitis after sinus surgery. Int Forum Allergy Rhinol. 2018;8(4):461–70.
10. Fokkens W, Lund V, Mullol J. European position paper on rhinosinusitis and nasal polyps. RhinolSuppl 2007;20:1-136
11. Soler ZM, Mace J, Smith TL. Symptom based presentation of chronic rhinosinusitis and symptom specific outcomes after endoscopic sinus surgery. Am J Rhinol 2008; 22: 297-301.
12. Garratt A, Scmidt L, Mackintosh A, Fitzpatrick R. Quality of life measurement: bibliographic study of patient assessed health outcome measures. BMJ 2002; 324: 1417-9.
13. Stammberger H, Posawetz W. Functional endoscopic sinus surgery: concept, indications and results of the Messerklinger technique. Eur Arch Otolaryngol 1990; 247: 63-76.
14. Van Oene CM, Van Reij EJ, Sprangers MA, Fokkens WJ. Quality- assessment of disease-specific quality of life questionnaires for rhinitis and rhinosinusitis: a systematic review. Allergy 2007; 62(12):1359v70.
15. Masterson, L., Ergo, F.M., Bewick, J., et al. (2016) Quality of Life Outcomes after Sinus Surgery in Allergic Fungal Rhinosinusitis versus Nonfungal Chronic Rhinosinusitis. American Journal of Rhinology & Allergy, 30, 30-35.
16. Lund VJ, Scadding GK. Objective assessment of endoscopic sinus surgery in the management of chronic rhinosinusitis: an update. J Laryngol Otol 1994; 108:749–53.
17. Fahmy FF, McCombe A, Mckiernan DC. Sino nasal assessment questionnaire, a patient focused rhinosinusitis specific outcome measure. Rhinology 2002; 40:195–7.
18. Durr GD, Desrosiers M. Evidence-based endoscopic sinus surgery. J Otolaryngol 2003; 32:101–6.
19. Linder JA, Atlas SJ. Health-related quality of life in patients with sinusitis. Curr Allergy Asthma Rep. 2004;4(6):490-5.
20. Piccirillo JF, Merritt MG Jr, Richards ML. Psychometric and clinimetric validity of the 20-Item Sino-Nasal Outcome Test (SNOT-20). Otolaryngol Head Neck Surg. 2002;126(1):41-7
21. Nair S, Bhadauria RS, Sharma S. Impact of Endoscopic Sinus Surgery on Symptom Manifestation of Chronic Rhinosinusitis. MJAFI 2010; 66:415.
22. Mishra DK, Bhatta R, Verma LR. Quality of life after functional endoscopic sinus surgery. Nepal Jor of Otol Head & Neck Surg 2010; 2(1):6–8.
23. Mace JC, Michael YL, Carlson NE, Litvack JR, Smith TL. Correlations between endoscopy score and quality of life changes after sinus surgery. Arch Otolaryngol Head Neck Surg 2010; 136:340–6.
24. Li Y, Zhang GH, Liu X. Clinical prognostic factors of chronic rhinosinusitis after endoscopic sinus surgery. ORL J Otorhinolaryngol Relat Spec 2008; 70:113–7.
25. Damm M, Quante G, Jungehuelsing M, Stennert E. Impact of functional Endoscopy Sinus Surgery on Symptoms and Quality of Life in Chronic Rhinosinusitis. Laryngoscope 2002; 112:310–5.
26. Bezerra TFP, Piccirillo JF, Fornazieri MA, Pilan RR, Pinna Fd, Padua FG, et al. Assessment of quality of life after endoscopic sinus surgery for chronic rhinosinusitis. Braz J Otorhinolaryngol 2012; 78:96-102.
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