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Histopathological inflammation and symptom outcomes after endoscopic sinus surgery
Author(s) -
Bhattacharyya Neil
Publication year - 2010
Publication title -
international forum of allergy and rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.503
H-Index - 46
eISSN - 2042-6984
pISSN - 2042-6976
DOI - 10.1002/alr.20000
Subject(s) - medicine , histopathology , antihistamine , endoscopic sinus surgery , sinusitis , sinus (botany) , chronic rhinosinusitis , functional endoscopic sinus surgery , rhinology , paranasal sinuses , gastroenterology , surgery , otorhinolaryngology , anesthesia , pathology , botany , biology , genus
Abstract Background To determine if histopathology of the sinus mucosa predicts symptomatic outcomes after endoscopic sinus surgery (ESS). Methods The histopathology of the sinus mucosa and preoperative and postoperative symptom scores from the Rhinosinusitis Symptom Inventory (RSI) for adults undergoing ESS for chronic rhinosinusitis (CRS) without polyposis were reviewed. Linear regression analysis was conducted to examine the relationship between tissue pathology inflammatory severity score and the postoperative RSI symptom scores, adjusting for baseline RSI scores, Lund score, postoperative topical steroid, antihistamine, and antibiotic use. Results A total of 112 patients were enrolled (average age, 41.2 years; 68.8% female) with a follow‐up of 19.1 ± 8.7 months (mean ± standard deviation [SD]). Mean preoperative and postoperative RSI domain scores for nasal symptoms and total symptoms were (52.4, 21.4) and (41.2, 17.7), respectively ( p < 0.001). Topical steroid utilization increased from 15.3 to 20.7 weeks ( p = 0.086) whereas antihistamine use and antibiotic use decreased by 1.4 and 1.6 weeks, respectively ( p = 0.594 and 0.092). Pathology severity score did not significantly predict postoperative symptom scores on any of the RSI symptom domains nor the total symptom score (all p > 0.05). Conclusion Although pathologic inflammation of the paranasal sinuses is inherent to CRS, increasing pathology severity at ESS does not predict poorer symptomatic outcomes after ESS. © 2011 ARS‐AAOA, LLC.