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Predictors of Surgical Outcomes After Functional Endoscopic Sinus Surgery in Chronic Rhinosinusitis

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Abstract

Chronic rhinosinusitis has an incidence of 15% in India. Functional endoscopic sinus surgery (FESS), in case of failed medical management, is the current treatment protocol in Chronic rhinosinusitis. This study aims to assess the outcome of FESS as measured by subjective quality of life indices; Rhinosinusitis Disability Index (RSDI) and Sinonasal Outcome Test (SNOT-22. It also assesses the predictive factors which influence the outcome after FESS. The study was conducted among 100 patients with Chronic Rhinosinusitis who underwent FESS, after failure of medical management. Immunocompromised or pregnant patients and patients with history of previous sinus surgery or malignancy were excluded from the study. The evaluation was done using Lund Kennedy endoscopy scores, Lund Mackay CT scan scores and RSDI and SNOT-22 questionnaires (baseline and 3 months post-op). Statistical analysis was done using Wilcoxon signed-rank test, Kruskall Wallis test, Mann Whitney test and Chi-square test. p < 0.05 was considered significant. RSDI and SNOTT 22 scores showed a mean change 34.78 and 33.04 respectively after FESS, with a p value of < 0.001, which was highly significant. The pre-operative factors which predicted a poor quality of life after FESS were smoking, Allergy and Asthma. Higher pre-operative Endoscopic and CT scores resulted in an improved quality of life after FESS. Gender, concurrent septoplasty and sinonasal polyposis did not influence the quality of life outcomes after FESS. The study determines the quality of life after FESS and also analyses the factors responsible for poor prognosis after functional endoscopic sinus surgery. This study will enable the ENT surgeons to adequately counsel the patients before surgery.

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Acknowledgements

We would like to thank department of Otolaryngology, Kasturba Medical College Attavara, Mangaluru, Manipal Academy of higher education for the support throughout the study.

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Authors and Affiliations

  1. Department of ENT & HNS, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Chinaoutpalli, Gannavaram, Krishna District, Vijayawada, Andhra Pradesh, India

    Jayakrishna Anne

  2. Kasturba Medical College, Department of Otorhinolaryngology, Manipal Academy of Higher Education, Mangalore, 575001, Karnataka, India

    Suja Sreedharan, Deviprasad Dosemane, Vijendra Shenoy, Panduranga M. Kamath & Sabah Mohd Zubair

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  1. Jayakrishna Anne
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  2. Suja Sreedharan
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  3. Deviprasad Dosemane
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  4. Vijendra Shenoy
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  5. Panduranga M. Kamath
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  6. Sabah Mohd Zubair
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by JA, DP, VSS, PMK. Writing—review and editing were done by SMZ and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Suja Sreedharan.

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Conflict of interest

Dr Suja S, Dr Jayakrishna A, Dr Devi P, Dr Vijendra S, Dr Panduranga M, Dr Sabah M declare that we have no conflict of interest.

Ethical approval

Ethical approval was taken by the ethics committee of Kasturba Medical College and Kasturba Hospital, Institutional Ethics Committee at the beginning of the study.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Anne, J., Sreedharan, S., Dosemane, D. et al. Predictors of Surgical Outcomes After Functional Endoscopic Sinus Surgery in Chronic Rhinosinusitis. Indian J Otolaryngol Head Neck Surg 74 (Suppl 2), 835–841 (2022). https://doi.org/10.1007/s12070-020-01855-4

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  • DOI: https://doi.org/10.1007/s12070-020-01855-4

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