Toby O. Steele

Health utility outcomes in patients undergoing medical management for chronic rhinosinusitis: a prospective multiinstitutional study

A health utility value represents an individuals preference for living in a specific health state and is used in cost‐utility analyses. This study investigates the impact of continuing medical therapy on health utility outcomes in patients with chronic rhinosinusitis (CRS).

Early detection of premalignant lesions and oral cancer.

Cancers of the oral cavity account for approximately 3% of malignancies diagnosed annually in the United States. As with other upper aerodigestive tract cancers, 5-year survival rates for oral cavity cancers decrease with delayed diagnosis. Cancers of the oral cavity are thought to progress from premalignant/precancerous lesions, beginning as hyperplastic tissue and developing into invasive squamous cell carcinoma. Despite the general accessibility of the oral cavity during physical examination, many malignancies are not diagnosed until late stages of disease. To prevent malignant transformation of these oral precursor lesions, multiple screening and detection techniques have been developed to address this problem.

Does comorbid anxiety predict quality of life outcomes in patients with chronic rhinosinusitis following endoscopic sinus surgery

Approximately 25% of patients with chronic rhinosinusitis (CRS) have comorbid anxiety and both conditions independently decrease quality of life (QOL). QOL outcomes for CRS and depression have garnered the majority of research attention, but efforts to better understand the impact of anxiety disorders on QOL are increasing. We evaluated the role of comorbid anxiety in patients with CRS undergoing endoscopic sinus surgery (ESS).

Improvements in sleep-related symptoms after endoscopic sinus surgery in patients with chronic rhinosinusitis

Sleep impairment is highly prevalent in patients with chronic rhinosinusitis (CRS). Although endoscopic sinus surgery (ESS) has been shown to improve overall patient‐reported sleep quality, the postoperative impact on individual sleep symptoms remains unclear.

Productivity outcomes following endoscopic sinus surgery for recurrent acute rhinosinusitis

We sought to evaluate preoperative and postoperative productivity losses and quality of life (QOL) impairment reported by patients with recurrent acute rhinosinusitis (RARS) as compared to patients with chronic rhinosinusitis without nasal polyposis (CRSsNP).

Sensitivity analysis and diagnostic accuracy of the Brief Smell Identification Test in patients with chronic rhinosinusitis

The Brief Smell Identification Test (BSIT) is an abbreviated version of the Smell Identification Test (SIT) used to assess olfactory function. Although the BSIT can be efficiently administered in under 5 minutes, the accuracy of the BSIT in relation to the SIT in patients with chronic rhinosinusitis (CRS) is unknown.

Improvements in psychological dysfunction after endoscopic sinus surgery for patients with chronic rhinosinusitis

Psychological dysfunction is highly prevalent among patients with chronic rhinosinusitis (CRS). Previous study has identified various measures of anxiety and depression as predictors of quality‐of‐life outcomes following endoscopic sinus surgery (ESS). Psychological dysfunction scores, as measured by the 22‐item Sino‐Nasal Outcome Test (SNOT‐22), have been found to influence treatment decision making in CRS. This study aims to further elucidate improvement in discrete psychological symptoms following ESS for CRS.

Patients electing medical vs surgical treatment: emotional domain of the Rhinosinusitis Disability Index associates with treatment selection

The Rhinosinusitis Disability Index (RSDI) consists of multiple subdomains shown to be useful in studying chronic rhinosinusitis (CRS). The objective of this study was to determine if RSDI subdomain scores are associated with selection of treatment modality (endoscopic sinus surgery [ESS] or continued medical management [CMM]) in subjects with CRS.

Patient-centered decision making: the role of the baseline SNOT-22 in predicting outcomes for medical management of chronic rhinosinusitis

For patients with chronic rhinosinusitis (CRS), the decision to elect continued medical management vs surgery is complex and involves tradeoffs between benefits, risks, and overall effectiveness of each therapy. The purpose of this study is to investigate whether baseline disease‐specific quality of life (QOL) can assist in predicting outcomes in patients with refractory CRS who elect continued medical management.

Does comorbid obesity impact quality of life outcomes in patients undergoing endoscopic sinus surgery

Both obesity and chronic rhinosinusitis (CRS) are characterized by inflammation. Furthermore, both disease processes are independently associated with decreases in quality‐of‐life (QOL). We sought to investigate the role of comorbid obesity in QOL outcomes in CRS patients undergoing endoscopic sinus surgery (ESS).