Open AccessSystematic Review of Change in Bodily pain after Sinus Surgery
Author(s) -
Chester Alexander C.,
Sindwani Raj,
Smith Timothy L.,
Bhattacharyya Neil
Publication year - 2008
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1016/j.otohns.2008.09.020
Subject(s) - medicine , population , normative , observational study , confidence interval , physical therapy , quality of life (healthcare) , medline , chronic rhinosinusitis , surgery , philosophy , nursing , environmental health , epistemology , political science , law
Objectives To determine whether bodily pain is increased in patients with chronic rhinosinusitis (CRS) and if bodily pain improves following endoscopic sinus surgery (ESS). Methods All studies reporting results of more than 10 adult patients analyzing the response of bodily pain to ESS were retrieved by searching MEDLINE, EMBASE, Web of Science, Cochrane databases, and additional web‐based sources (from January 1, 1980, to May 1, 2008); by examining bibliographies of retrieved articles; and by contacting investigators in the field. Results Of 279 ESS symptom outcome studies, only studies measuring results using the 36‐Item Short Form Health Survey (SF‐36) quality‐of‐life survey instrument measured bodily pain. Eleven observational ESS studies (1019 patients) reported mean preoperative SF‐36 bodily pain scores at 0.89 SD below general population norms (24% more severe bodily pain than general population norms) and significantly below norms for a population 25 years older. Using a repeated‐measures design, nine of 11 studies noted significant improvement in SF‐36 bodily pain domain scores following ESS, with a moderate‐sized combined effect of 0.55 (95% confidence interval, 0.45–0.64; I 2 = 44%) using the fixed‐effects model. This pooled effect corresponded to a mean improvement of 11.8 U on the SF‐36 bodily pain domain scale. Conclusions Bodily pain is increased in patients with CRS awaiting ESS, exceeding the normative bodily pain scores of a general normative population 25 years older. Using within‐subject comparisons, a clinically and statistically significant improvement in bodily pain is noted after ESS, an improvement similar to that previously described for fatigue.