Does time to endoscopic sinus surgery impact outcomes in chronic rhinosinusitis? Prospective findings from the national comparative audit of surgery for nasal polyposis and chronic rhinosinusitis

Claire Hopkins*, J. Rimmer, V. J. Lund

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    95 Citations (Scopus)

    Abstract

    Objectives: Patients with chronic rhinosinusitis refractory to medical management undergo elective surgery. The time from initial diagnosis to surgery varies considerably. The impact of this delay on surgical success has never previously been evaluated. Design: First-time patients within the National Comparative Audit of Surgery for Nasal Polyposis and Chronic Rhinosinusitis were grouped based on time to surgery: 1) Early cohort: < 12 months; 2) Mid cohort: 12-60 months; and 3) Late cohort: > 60 months. Co-morbidities and preoperative CT scores were analysed for all patients. Main outcome measures: The 22-item Sino-Nasal Outcome Test scores (SNOT-22) were collected at 0, 3, 12 and 60-months. Absolute and relative SNOT-22 changes from baseline were evaluated. Results: Asthma and allergies were significantly more prevalent in the Late versus the Early and Mid-cohorts. In addition, patients in the Late cohort had greater symptom burden on the SNOT-22 and more extensive preoperative radiographic disease as determined by Lund-Mackay (LM) scores. SNOT-22 scores demonstrated greater percentage improvements in the Early versus the Midand Late cohorts, at all time points after surgery. At 12 and 60 months after surgery, significantly more patients in the Early group achieved a clinically important change in SNOT-22 scores compared with the other groups. These differences were maintained when cohorts were matched for preoperative co-morbidities. Conclusion: Patients with asthma and/or allergies are more likely to experience delayed surgical intervention versus other patients. Overall, patients with delayed surgery reported less improvement in SNOT-22 scores than patients treated at earlier time points, regardless of co-morbid status. Delaying surgical intervention may worsen long term clinical outcomes.

    Original languageEnglish
    Pages (from-to)10-17
    Number of pages8
    JournalRhinology
    Volume53
    Issue number1
    DOIs
    Publication statusPublished - 2015

    Keywords

    • Outcomes
    • Sinus surgery
    • Sinusitis

    Fingerprint

    Dive into the research topics of 'Does time to endoscopic sinus surgery impact outcomes in chronic rhinosinusitis? Prospective findings from the national comparative audit of surgery for nasal polyposis and chronic rhinosinusitis'. Together they form a unique fingerprint.

    Cite this