More data on FESS outcomes

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Eosinophilia and polyps result in globally lower improvements after surgery - this does not mean that surgery cannot improve these conditions, but that, as a whole, we fare worse than other people after surgery.--------Otolaryngol Head Neck Surg. 2010 Jan;142(1):64-71. Epub 2009 Nov 22.Impact of mucosal eosinophilia and nasal polyposis on quality-of-life outcomes after sinus surgery.Soler

ZM, Sauer

D, Mace

J,

TL.Department of Otolaryngology-Head and Neck Surgery, Oregon Sinus Center, Portland, OR, USA.OBJECTIVE: Assess whether the presence of mucosal eosinophilia correlates with surgical outcomes in patients with chronic rhinosinusitis. STUDY DESIGN: Prospective cohort. SETTING: Tertiary medical center. SUBJECTS AND METHODS: Adult patients with chronic rhinosinusitis were prospectively enrolled, and demographic data

and medical comorbidities were recorded. Preoperative quality of life (QOL) was measured by the Chronic Sinusitis Survey (CSS), Rhinosinusitis

Disability Index (RSDI), and Short Form-36 General Health Survey (SF-36). Sinus mucosal specimens were collected at the time of surgery and the degree of eosinophilia quantified. Postoperative QOL was measured, and differences in QOL improvement were compared between those

with and without eosinophilia.RESULTS: A total of 102 patients had both histopathological and QOL outcome data available for review. Follow-up averaged 16.5 months. Patients with eosinophilia showed significantly less improvement in the RSDI total (17.9 vs 25.0; P = 0.044), RSDI functional (5.7 vs 8.8; general health subscale; P = 0.018), CSS medication (3.6 vs 17.3; P = 0.013), SF-36 general health (0.6 vs 9.6; P = 0.008), SF-36 physical role (16.1 vs 34.7; P = 0.036), and SF-36 vitality (11.9 vs 21.2; P = 0.034) scales than those without eosinophilia. The greatest improvement in QOL was seen in patients without eosinophilia or polyps, with the least improvement seen in those

with eosinophilia but without polyps. CONCLUSION: The presence of mucosal eosinophilia at the time of surgery consistently predicted less improvement in both disease-specific and general QOL compared with patients without eosinophilia. The impact of eosinophilia on outcomes was greatest for patients without nasal polyposis, a group that demonstrated the least improvement in QOL measures.