Appropriateness criteria predict outcomes for sinus surgery and may aid in future patient selection

The Laryngoscope
Daniel M BeswickTimothy L Smith

Abstract

Appropriateness criteria to determine surgical candidacy for chronic rhinosinusitis (CRS) have recently been described. This study stratified patients who underwent endoscopic sinus surgery (ESS) according to these new appropriateness criteria and evaluated postoperative improvements among appropriateness categories. Adult patients with uncomplicated CRS electing ESS were prospectively enrolled in a multi-institutional cohort study between March 2011 and June 2015 to assess outcomes. Subsequently, appropriateness criteria that consider preoperative medical therapy, 22-item SinoNasal Outcome Test (SNOT-22) scores, and Lund-Mackay computed tomography scores were retrospectively applied. A total of 92.6% (436 of 471) were categorized as "appropriate" ESS candidates, 3.8% (18 of 471) as "uncertain," and 3.6% (17 of 471) as "inappropriate." Among uncertain patients, two-thirds (12 of 18) had identifiable reasons for undergoing ESS, most commonly oral corticosteroid intolerance (n = 6). Postoperative follow-up was available for 79% (n = 372). Clinically significant SNOT-22 improvements occurred in both appropriate and uncertain groups (all P < 0.050) but not among the inappropriate group. The inappropriate group reported less mean im...Continue Reading

Associated Clinical Trials

References

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May 31, 2017·International Forum of Allergy & Rhinology·Joshua M LevyTimothy L Smith

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Citations

Aug 28, 2020·Current Medical Research and Opinion·Stephanie ChenEmily Rosta
Oct 23, 2019·Laryngoscope Investigative Otolaryngology·Ann Helen NilsenVegard Bugten
Nov 26, 2020·International Forum of Allergy & Rhinology·Richard R OrlandiBing Zhou
Sep 30, 2021·International Forum of Allergy & Rhinology·Matthew LiuPhilip G Chen

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