Endoscopic sinus surgery outcomes in CRS: quality of life and correlations with NOSE scale in a prospective cohort study
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RHINOLOGY
Endoscopic sinus surgery outcomes in CRS: quality of life and correlations with NOSE scale in a prospective cohort study Athanasios Saratziotis1 · Enzo Emanuelli2 · Claudia Zanotti2 · George Mireas3 · Pavlos Pavlidis4 · Maria Ferfeli5 · Jiannis Hajiioannou1 Received: 26 May 2020 / Accepted: 28 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background To evaluate the impact of endoscopic sinus surgery (ESS) on clinical outcomes, quality of life (QoL) and Nasal Obstruction and Symptom Evaluation (NOSE) scale in patients with CRSwNP and CRSsNP. An additional question that needs to be investigated is whether there is a correlation between patients at the age of relapse. Methodology/principal A prospective cohort study of 150 subjects [96 males, 54 females, mean age: 51.99 ± (15.73)]. The SNOT-22 and NOSE questionnaires were used to measure the patients’ QoL and their nasal blockage symptoms, respectively. Endoscopic and computerized tomography (CT) scores depicted the objective findings. Results Following ESS, the endoscopic scale showed a significant improvement in 83.85% of patients. QoL measured with SNOT-22 improved by 78.85% and with NOSE scale by 92.10%. Also, a statistically significant correlation was found between NOSE, SNOT-22 and the Lund–Kennedy scale. Recurrence was observed in 13 patients during follow-up. There was no statistically significant correlation between age, gender, smoking and recurrence tendency. Patients with baseline SNOT-22 and NOSE scores lower than 30 typically fail to obtain a clinically meaningful benefit. Patients with a rate greater than or equal to 40 achieved a minimal clinically important difference (MCID) of 83.9% and had an average symptom reduction (RI) rate of 60.3%. Conclusions ESS is an important treatment option for symptomatic patients with CRSwNP and CRSsNP. Both objective and subjective measurements including QoL improved significantly, and the results stabilized at 12 to 18 months. The NOSE scale is a sensitive outcome measure in the CRS population, including subjects with and without nasal polyps. In our study, SNOT-22 and NOSE are excellent predictors of postoperative improvement. Keywords Chronic rhinosinusitis · Endoscopic sinus surgery · Quality of life · Sinonasal outcome test-22 · NOSE scale
Introduction
* Athanasios Saratziotis [email protected] 1
Department of Otolaryngology, University Hospital of Larisa, University of Thessaly, Larissa, Greece
2
Department of Otorhinolaryngology and Otologic Surgery, University of Padova, Padua, Italy
3
Department of Otorhinolaryngology, 251 General Hospital of the Hellenic Airforce, Athens, Greece
4
Department of Otorhinolaryngology, General Hospital of Papanikolaou, Thessaloniki, Greece
5
Department of Applied Informatics, University of Macedonia, Thessaloniki, Greece
Chronic rhinosinusitis (CRS) is an inflammatory condition characterized by nasal mucosa and paranasal sinus inflammation. Clinical symptoms include nasal congestion, postnasal drip
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