Adam S. DeConde

SNOT‐22 quality of life domains differentially predict treatment modality selection in chronic rhinosinusitis

Prior study demonstrated that baseline 22‐item Sino‐Nasal Outcome Test (SNOT‐22) aggregate scores accurately predict selection of surgical intervention in patients with chronic rhinosinusitis (CRS). Factor analysis of the SNOT‐22 survey has identified five distinct domains that are differentially impacted by endoscopic sinus surgery (ESS). This study sought to quantify SNOT‐22 domains in patient cohorts electing both surgical or medical management and postinterventional change in these domains.

Chronic rhinosinusitis: Epidemiology and burden of disease.

Background Chronic rhinosinusitis (CRS) is based on sinonasal symptoms coupled with sinonasal tissue inflammation. Establishing the epidemiology and prevalence of CRS, therefore, is challenging given that confirming objective evidence of sinonasal inflammation on a large scale is not feasible. Although the sinonasal symptoms are well documented at the sinonasal level, analysis of emerging data indicates that the impact on the general-health–related domains of health are the symptoms that are most bothersome to patients’ quality of life. Objective To review the literature on the epidemiology and the societal and individual burdens of CRS. Methods A literature review. Results A refinement of questionnaire-based surveys coupled with sampling of respondents for accuracy likely provides the most accurate assessment of prevalence. There is geographic variation, but, in North American and European countries, the rates range from 4.5 to 12%. Although CRS is marked by sinonasal symptoms, the most problematic symptoms for patients seem to be the symptoms that affect general-health–related domains. Diminished sleep, productivity, cognition, mood, and fatigue are associated with the decision to elect surgical intervention and are associated with diminished healthy utility values. Direct costs of CRS have been well documented, but new data on the indirect costs of decreased productivity surpass direct costs, at

Comparative effectiveness of medical and surgical therapy on olfaction in chronic rhinosinusitis: a prospective, multi-institutional study.

12.8 billion dollars per year in the United States. Conclusion CRS is a common disease with a large and vast symptom burden with high indirect costs. Although clinicians are focused by guidelines on sinus-specific symptoms, patients seem to be most impacted by the general-health–related consequences of CRS. An expanded understanding of the extent and costs of these symptoms will allow for a cost-effective allocation of limited health care resources.

Using Preoperative SNOT-22 Score to Inform Patient Decision for Endoscopic Sinus Surgery

Evidence comparing the impact of medical and surgical management of chronic rhinosinusitis on olfactory function is limited. This study evaluates olfactory outcomes in patients who failed initial medical management and elect either continued medical management or endoscopic sinus surgery (ESS) followed by medical management.

Prevalence of polyp recurrence after endoscopic sinus surgery for chronic rhinosinusitis with nasal polyposis

The purpose of this study is to improve patient understanding of surgical outcomes while they make a preference‐sensitive decision regarding electing endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS).

Longitudinal improvement and stability of the SNOT‐22 survey in the evaluation of surgical management for chronic rhinosinusitis

Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a disease process that is driven, in part, by intrinsic mucosal inflammation. Surgery plus continued medical therapy is commonly elected by medically recalcitrant, symptomatic patients. The objective was to evaluate the prevalence of nasal polyp recurrence up to 18 months after endoscopic sinus surgery (ESS) with congruent continuing medical management.

Investigation of change in cardinal symptoms of chronic rhinosinusitis after surgical or ongoing medical management

Patients with chronic rhinosinusitis (CRS) have significant quality‐of‐life (QOL) improvements following endoscopic sinus surgery (ESS). These improvements remain stable and persist between 6 months and 20 months as measured by the Rhinosinusitis Disability Index and the Chronic Sinusitis Survey. There has yet to be an evaluation of the longitudinal stability of the 22‐item Sino‐Nasal Outcome Test (SNOT‐22) after ESS in patients with CRS.

Outcomes of complete vs targeted approaches to endoscopic sinus surgery

Chronic rhinosinusitis (CRS) has been defined as inflammation of the paranasal sinuses lasting at least 12 weeks with corresponding 2 or more “cardinal symptoms” that include: (1) nasal obstruction; (2) thick nasal discharge; (3) facial pain/pressure; and (4) reduction or loss of sense of smell. Although prior studies have investigated symptoms of CRS after sinus surgery, none have compared the outcomes of these specific symptoms to ongoing medical therapy.

Characterization of facial pain associated with chronic rhinosinusitis using validated pain evaluation instruments.

Functional endoscopic sinus surgery (FESS) was historically predicated on targeted widening of narrow anatomic structures that caused postobstructive persistent sinus inflammation. It is now clear that chronic rhinosinusitis (CRS) is a multifactorial disease with subsets of patients which may require a more extensive surgical approach. This study compares quality‐of‐life (QOL) and disease severity outcomes after FESS based on the extent of surgical intervention.

International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis

Prior investigations into facial pain associated with chronic rhinosinusitis (CRS) have yielded important results, but have yet to use pain‐specific outcome measures. This study seeks to characterize facial pain associated with CRS using validated pain‐specific instruments.