Abstract
This prospective study assesses outco mes at 6 weeks and 7 months after radical ethmoid surgery in 65 patients with nasal polyposis using a new and detailed instrument, the DyNaChron questionnaire, which was filled in the day prior to surgery and at 6 weeks and 7 months after surgery at follow-up visits. Before surgery, the leading bothersome symptoms were olfactory disturbances (7.74 ± 2.81) and nasal obstruction (6.66 ± 2.28). After surgery (6th week and 7th month), there was a clear improvement of all symptoms including nasal obstruction, olfactory disturbances, anterior rhinorrhea, postnasal discharge, facial pain/headache and cough in comparison to baseline (p < 0.0001). Nasal obstruction was the most improved symptom (effect size of 2.24). At 7th post-operative month, the sense of smell continued to improve slightly. By contrast, the postnasal discharge score that was significantly improved at 6th post-operative week tended to worsen at 7 months (p = 0.0045). Before surgery, strong psychosocial impacts were observed in association with nasal obstruction and anterior rhinorrhea. The physical impacts of each symptom were proportionally correlated to the symptom score before and after surgery. The quality of life (QOL) related to each symptom was clearly better at 6 weeks and remained steady at 7 months after surgery. In conclusion, olfactory disorders and postnasal rhinorrhea were the main remaining symptoms after sinus surgery despite a global improvement of symptoms and quality of life. The earlier time point to stabilize QOL outcomes of endoscopic sinus surgery could be suggested at 6 weeks after surgery.
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References
Bhattacharyya T, Piccirillo J, Wippold FJ 2nd (1997) Relationship between patient-based descriptions of sinusitis and paranasal sinus computed tomographic findings. Arch Otolaryngol Head Neck Surg 123(11):1189–1192
Shields G, Seikaly H, LeBoeuf M, Guinto F, LeBoeuf H, Pincus T, Calhoun K (2003) Correlation between facial pain or headache and computed tomography in rhinosinusitis in Canadian and US subjects. Laryngoscope 113(6):943–945
Hwang PH, Irwin SB, Griest SE, Caro JE, Nesbit GM (2003) Radiologic correlates of symptom-based diagnostic criteria for chronic rhinosinusitis. Otolaryngol Head Neck Surg 128(4):489–496
Basu S, Georgalas C, Kumar BN, Desai S (2005) Correlation between symptoms and radiological findings in patients with chronic rhinosinusitis: an evaluation study using the Sinonasal Assessment Questionnaire and Lund-Mackay grading system. Eur Arch Otorhinolaryngol 262(9):751–754
Wright ED, Agrawal S (2007) Impact of perioperative systemic steroids on surgical outcomes in patients with chronic rhinosinusitis with polyposis: evaluation with the novel Perioperative Sinus Endoscopy (POSE) scoring system. Laryngoscope 117(11 Pt 2 Suppl 115):1–28
Fokkens WJ, Lund VJ, Mullol J, Bachert C, Alobid I, Baroody F et al (2012) European position paper on rhinosinusitis and nasal polyps. Rhinol Suppl 23:1–298 (3 p preceding table of contents)
Jankowski R (2011) Revisiting human nose anatomy: phylogenic and ontogenic perspectives. Laryngoscope 121(11):2461–2467
Jankowski R (2013) The evo-devo origin of the nose. Anterior Skull Base and Midface, Springer Verlag Paris. ISBN 978-2817804217
Alobid I, Benítez P, Bernal-Sprekelsen M, Roca J, Alonso J, Picado C, Mullol J (2005) Nasal polyposis and its impact on quality of life: comparison between the effects of medical and surgical treatments. Allergy 60(4):452–458
Banerji A, Piccirillo JF, Thawley SE, Levitt RG, Schechtman KB, Kramper MA, Hamilos DL (2007) Chronic rhinosinusitis patients with polyps or polypoid mucosa have a greater burden of illness. Am J Rhinol 21(1):19–26
Bugten V, Nordgård S, Romundstad P, Steinsvåg S (2008) Chronic rhinosinusitis and nasal polyposis; indicia of heterogeneity. Rhinology 46(1):40–44
Poetker DM, Mendolia-Loffredo S, Smith TL (2007) Outcomes of endoscopic sinus surgery for chronic rhinosinusitis associated with sinonasal polyposis. Am J Rhinol 21(1):84–88
Deal RT, Kountakis SE (2004) Significance of nasal polyps in chronic rhinosinusitis: symptoms and surgical outcomes. Laryngoscope 114(11):1932–1935
Hopkins C, Browne JP, Slack R, Lund V, Topham J, Reeves B, Copley L, Brown P, van der Meulen J (2006) The national comparative audit of surgery for nasal polyposis and chronic rhinosinusitis. Clin Otolaryngol 31(5):390–398
Devars du Mayne M, Prulière-Escabasse V, Zerah-Lancner F, Coste A, Papon JF (2011) Polypectomy compared with ethmoidectomy in the treatment of nasal polyposis. Arch Otolaryngol Head Neck Surg 137(2):111–117
Jankowski R, Bodino C (2003) Evolution of symptoms associated to nasal polyposis following oral steroid treatment and nasalization of the ethmoid–radical ethmoidectomy is functional surgery for NPS. Rhinology 41(4):211–219
Alobid I, Bernal-Sprekelsen M, Mullol J (2008) Chronic rhinosinusitis and nasal polyps: the role of generic and specific questionnaires on assessing its impact on patients’ quality of life. Allergy 63(10):1267–1279
Kacha S, Guillemin F, Jankowski R (2012) Development and validity of the DyNaChron questionnaire for chronic nasal dysfunction. Eur Arch Otorhinolaryngol 269(1):143–153
Jankowski R, Pigret D, Decroocq F, Blum A, Gillet P (2006) Comparison of radical (nasalisation) and functional ethmoidectomy in patients with severe sinonasal polyposis. A retrospective study. Rev Laryngol Otol Rhinol (Bord) 127(3):131–140
Jankowski R (2010) Nasalisation in the surgical treatment of nasal polyposis. In: Onerci M, Ferguson BJ (eds) Nasal polyposis: pathogenesis, medical and surgical treatment. Springer, Berlin, pp 265–274
Norman GR, Sloan JA, Wyrwich KW (2003) Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation. Med Care 41(5):582–592
Ehnhage A, Olsson P, Kölbeck KG, Skedinger M, Dahlén B, Alenius M, Stjärne P, NAFS Study Group (2009) Functional endoscopic sinus surgery improved asthma symptoms as well as PEFR and olfaction in patients with nasal polyposis. Allergy 64(5):762–769
Ehnhage A, Olsson P, Kölbeck KG, Skedinger M, Stjärne P, NAFS Study Group (2012) One year after endoscopic sinus surgery in polyposis: asthma, olfaction, and quality-of-life outcomes. Otolaryngol Head Neck Surg 146(5):834–841
Radenne F, Lamblin C, Vandezande LM, Tillie-Leblond I, Darras J, Tonnel AB, Wallaert B (1999) Quality of life in nasal polyposis. J Allergy Clin Immunol. 104(1):79–84
Conte LJ, Holzberg N (1996) Functional endoscopic sinus surgery, symptomatic relief: a patient perspective. Am J Rhinol 10(3):135–140
Soler ZM, Smith TL (2010) Quality-of-life outcomes after endoscopic sinus surgery: how long is long enough? Otolaryngol Head Neck Surg 143(5):621–625
Young J, Frenkiel S, Tewfik MA, Mouadeb DA (2007) Long-term outcome analysis of endoscopic sinus surgery for chronic sinusitis. Am J Rhinol 21(6):743–747
Bhattacharyya N (2004) Symptom outcomes after endoscopic sinus surgery for chronic rhinosinusitis. Arch Otolaryngol Head Neck Surg 130(3):329–333
Soler ZM, Mace J, Smith TL (2008) Symptom-based presentation of chronic rhinosinusitis and symptom-specific outcomes after endoscopic sinus surgery. Am J Rhinol 22(3):297–301
Dietz de Loos DA, Hopkins C, Fokkens WJ (2013) Symptoms in chronic rhinosinusitis with and without nasal polyps. Laryngoscope 123(1):57–63
Serrano E, Neukirch F, Pribil C, Jankowski R, Klossek JM, Chanal I, El Hasnaoui A (2005) Nasal polyposis in France: impact on sleep and quality of life. J Laryngol Otol 119(7):543–549
Craig TJ, Ferguson BJ, Krouse JH (2008) Sleep impairment in allergic rhinitis, rhinosinusitis, and nasal polyposis. Am J Otolaryngol 29(3):209–217
Temmel AF, Quint C, Schickinger-Fischer B, Klimek L, Stoller E, Hummel T (2002) Characteristics of olfactory disorders in relation to major causes of olfactory loss. Arch Otolaryngol Head Neck Surg 128(6):635–641
Nguyen DT, Gauchotte G, Nguyen-Thi PL, Jankowski R (2013) Does surgery of the olfactory clefts modify the sense of smell? Am J Rhinol Allergy 27(4):317–321
Fahy C, Jones NS (2001) Nasal polyposis and facial pain. Clin Otolaryngol Allied Sci 26(6):510–513
Eweiss AZ, Lund VJ, Barlow J, Rose G (2013) Do patients with chronic rhinosinusitis with nasal polyps suffer with facial pain? Rhinology 51(3):231–235
Daudia AT, Jones NS (2002) Facial migraine in a rhinological setting. Clin Otolaryngol Allied Sci 27(6):521–525
Lanza DC, Kennedy DW (1997) Adult rhinosinusitis defined. Otolaryngol Head Neck Surg 117(3 Pt 2):S1–S7
Van Oene CM, van Reij EJ, Sprangers MA, Fokkens WJ (2007) Quality-assessment of disease-specific quality of life questionnaires for rhinitis and rhinosinusitis: a systematic review. Allergy 62(12):1359–1371
Chester AC, Antisdel JL, Sindwani R (2009) Symptom-specific outcomes of endoscopic sinus surgery: a systematic review. Otolaryngol Head Neck Surg 140(5):633–639
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Nguyen, D.T., Guillemin, F., Arous, F. et al. Assessment of quality-of-life outcomes after surgery for nasal polyposis with the DyNaChron questionnaire. Eur Arch Otorhinolaryngol 272, 367–375 (2015). https://doi.org/10.1007/s00405-014-3109-0
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DOI: https://doi.org/10.1007/s00405-014-3109-0