Are chronic rhinosinusitis (CRS)-specific health-related quality of life (HRQOL) outcomes affected by concurrent septoplasty performed during endoscopic sinus surgery (ESS) for medically refractory CRS?
Background: Septoplasty is commonly performed during ESS. Some might question whether ESS outcomes, even CRS-specific outcomes, are the result of the ESS, the septoplasty or some combination of the two. Because objective testing is poorly correlated with the subjective symptoms of nasal obstruction, it is commonly accepted that the most clinically relevant outcomes following septoplasty are patient-based measures, such as QOL.
Explore this issue:December 2011
Study design: Prospective, multi-center cohort study.
Setting: Division of Rhinology and Sinus Surgery, Oregon Sinus Center, Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland; Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Penn.
Synopsis: The study included 221 patients with medically refractory CRS without nasal polyposis who elected primary ESS. The patients were placed into two cohorts: concurrent septoplasty or no septoplasty during ESS. The main outcomes were measured by two CRS-specific HRQOL instruments. The researchers found no differences in CRS-specific HRQOL improvements on all Rhinosinusitis Disability Index and Chronic Sinusitis Survey measures following ESS between cohorts, with or without septoplasty. In patients with medically refractory CRS, the presence of septal deviation did not result in a different CRS-specific symptom presentation when compared with patients without septal deviation.
Bottom line: Concurrent septoplasty does not appear to affect CRS-specific HRQOL or symptom outcomes and does not function as a confounding factor in HRQOL improvement.
Citation: Rudmik L, Mace J, Ferguson BJ, et al. Concurrent septoplasty during endoscopic sinus surgery for chronic rhinosinusitis: does it confound outcomes assessment? Laryngoscope. 2011;121(12):2679-2683.
—Reviewed by Sue Pondrom