In reference to low-stage computed tomography chronic rhinosinusitis: what is the role of endoscopic sinus surgery?

Concurrent septoplasty during endoscopic sinus surgery for chronic rhinosinusitis: does it confound outcomes assessment?

OBJECTIVES/HYPOTHESIS

To determine if chronic rhinosinusitis (CRS)-specific health-related quality-of-life (HRQoL) outcomes are affected by concurrent septoplasty performed during endoscopic sinus surgery (ESS) for medically refractory CRS.

STUDY DESIGN

Prospective, multicenter cohort study.

METHODS

A total of 221 patients with medically refractory CRS without nasal polyposis who elected primary ESS were included in this study. Patients were dichotomized into two cohorts: concurrent septoplasty (n = 108) or no septoplasty (n = 113) during ESS. The main outcomes of interest included two CRS-specific HRQoL instruments: the Rhinosinusitis Disability Index (RSDI) and the Chronic Sinusitis Survey (CSS). Symptom presentation was assessed using eight sinonasal visual analog scale (VAS) symptom scores.

RESULTS

There were no differences in CRS-specific HRQoL improvements on all RSDI and CSS measures following ESS between cohorts with or without septoplasty (all P > .05). In patients with medically refractory CRS, the presence of septal deviation did not result in a different CRS-specific symptom presentation compared to patients without septal deviation (all baseline VAS symptom score comparisons P > .295).

CONCLUSIONS

To optimize nasal patency and improve surgical access, septoplasty is commonly performed during ESS. Based on the results of this study, concurrent septoplasty does not appear to affect CRS-specific HRQoL or symptom outcomes and does not function as a confounding factor in HRQoL improvement.