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Ma HJ, Orozco FR, Raj CK, Herrera K, Parsons JC, Kim I, Hur K. Effects of Language, Age, and Hearing Loss on Health-Related Quality of Life. OTO Open 2023; 7:e55. [PMID: 37251543 PMCID: PMC10225048 DOI: 10.1002/oto2.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 04/14/2023] [Accepted: 04/30/2023] [Indexed: 05/31/2023] Open
Abstract
Objective To understand the effect of age on health-related quality of life (HRQoL) in patients with hearing loss and determine how primary language mediates this relationship. Study Design Cross-sectional study. Setting General otolaryngology clinic in Los Angeles. Methods Demographics, medical records, and HRQoL data of adult patients presenting with otology symptoms were reviewed. HRQoL was measured using the Short-Form 6-Dimension utility index. All patients underwent audiological testing. A path analysis was performed to generate a moderated path analysis with HRQoL as the primary outcome. Results This study included 255 patients (mean age = 54 years; 55% female; 27.8% did not speak English as a primary language). Age had a positive direct association with HRQoL (p < .001). However, the direction of this association was reversed by hearing loss. Older patients exhibited significantly worse hearing (p < .001), which was negatively associated with HRQoL (p < .05). Primary language moderated the relationship between age and hearing loss. Specifically, patients who did not speak English as a primary language had significantly worse hearing (p < .001) and therefore worse HRQoL (p < .01) than patients who spoke English as a primary language with hearing loss. Increasing age was associated with bilateral hearing loss compared to unilateral hearing loss (p < .001) and subsequently lower HRQoL (p < .001). Polypharmacy (p < .01) and female gender (p < .01) were significantly associated with lower HRQoL. Conclusion Among otolaryngology patients with otology symptoms, older age and not speaking English as a primary language were associated with worse hearing and subsequently lower HRQoL.
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Affiliation(s)
- Harrison J. Ma
- Caruso Department of Otolaryngology–Head and Neck Surgery, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Francis Reyes Orozco
- Caruso Department of Otolaryngology–Head and Neck Surgery, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Christine K. Raj
- Caruso Department of Otolaryngology–Head and Neck Surgery, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Kevin Herrera
- Caruso Department of Otolaryngology–Head and Neck Surgery, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - John C. Parsons
- Caruso Department of Otolaryngology–Head and Neck Surgery, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Ian Kim
- Department of Population and Public Health Sciences, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Kevin Hur
- Caruso Department of Otolaryngology–Head and Neck Surgery, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
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2
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Shah VP, Haimowitz SZ, Desai AD, Barron K, Patel P, Fang CH, Grube JG, Baredes S, Eloy JA. Sex Disparities in Pediatric Acute Rhinosinusitis: A National Perspective. Otolaryngol Head Neck Surg 2022; 167:760-768. [PMID: 35133910 DOI: 10.1177/01945998221077190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study aims to provide an age-stratified analysis of associations with patient sex in pediatric inpatients with acute rhinosinusitis (ARS). STUDY DESIGN Retrospective cohort study. SETTING National administrative database. METHODS The 2016 Kids' Inpatient Database was queried for pediatric inpatients (<21 years old) with ARS (ICD-10 J01). Orbital and intracranial sequelae were selected via ICD-10 codes. Statistical associations by sex were determined via univariate and multivariable analyses. Weighted measures are reported to provide national estimates. RESULTS Of the 5882 patients identified with ARS, 2404 (40.9%) were female and 3478 (59.1%) were male. Male patients were younger than female patients (mean, 9.3 vs 9.9 years; P < .001). Multivariable analysis indicated that males and females had similar total charges ($71,094 vs $66,892, P = .464) and length of stay (5.8 vs 6.1 days, P = .263). However, male patients underwent more procedures (1.8 vs 1.5, P < .001). Mortality was similar between male and female patients (odds ratio [OR], 0.91; P = .664). Male patients also had increased odds for having orbital (OR, 1.58; P < .001) and intracranial (OR, 1.99; P < .001) complications. Differences in sex-dependent sequela risk were starkest in patients aged 14 to 20 years, with male patients being more likely to have orbital (OR, 2.91; P < .001) and intracranial (OR, 3.86; P < .001) complications. CONCLUSION In a cohort of pediatric inpatients with ARS, males have increased odds for orbital and intracranial sequelae and undergo more procedures than females. However, males and females have similar charges and length of stay. Our study highlights age-stratified differences in ARS across patient sex.
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Affiliation(s)
- Vraj P Shah
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Sean Z Haimowitz
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Amar D Desai
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Kendyl Barron
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Prayag Patel
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Christina H Fang
- Department of Otolaryngology-Head and Neck Surgery, Albert Einstein School of Medicine/Montefiore Medical Center, Bronx, New York, USA
| | - Jordon G Grube
- Department of Otolaryngology, Albany Medical Center, Albany, New York, USA
| | - Soly Baredes
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.,Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Jean Anderson Eloy
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.,Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, USA.,Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.,Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, USA.,Department of Otolaryngology and Facial Plastic Surgery, Saint Barnabas Medical Center-RWJBarnabas Health, Livingston, New Jersey, USA
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3
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Bartosik TJ, Liu DT, Campion NJ, Villazala-Merino S, Janik S, Dahm V, Mueller CA, Vyskocil E, Stanek V, Quint T, Bangert C, Eckl-Dorna J, Schneider S. Differences in men and women suffering from CRSwNP and AERD in quality of life. Eur Arch Otorhinolaryngol 2020; 278:1419-1427. [PMID: 33063145 PMCID: PMC8057986 DOI: 10.1007/s00405-020-06418-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 10/03/2020] [Indexed: 11/01/2022]
Abstract
PURPOSE While the overall impact of chronic rhinosinusitis (CRS) on patients' health is diverse, many affected individuals have a substantially impaired quality of life (QoL). The aim of this study was to evaluate the impact of sex-associated differences specifically in the subgroups of CRS with nasal polyps (CRSwNP) and aspirin-exacerbated respiratory disease (AERD) by assessing QoL parameters in women and men separately. METHODS In a retrospective single-center study, 59 patients with CRSwNP (39 males and 20 females) and 46 patients with AERD (18 males and 28 females) were included. Patient-reported outcome measures (PROM) evaluating QoL via the Sino-Nasal Outcome Test-20 German Adapted Version (SNOT-20 GAV) as well as the total polyp score (TPS) were analysed. RESULTS There was no significant difference in TPS (p = 0.5550) and total SNOT-20 GAV scores (p = 0.0726) between male or female patients with CRSwNP or AERD. Furthermore, no significant sex differences were found within disease groups regarding the subcategories of the SNOT-20 GAV items. CONCLUSION Thus, quality of life is severely impaired in patients suffering from various forms of CRS regardless of their sex.
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Affiliation(s)
- Tina J Bartosik
- Department of Otorhinolaryngology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - David T Liu
- Department of Otorhinolaryngology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Nicholas J Campion
- Department of Otorhinolaryngology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Sergio Villazala-Merino
- Department of Otorhinolaryngology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Stefan Janik
- Department of Otorhinolaryngology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Valerie Dahm
- Department of Otorhinolaryngology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Christian A Mueller
- Department of Otorhinolaryngology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Erich Vyskocil
- Department of Otorhinolaryngology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Victoria Stanek
- Department of Otorhinolaryngology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Tamara Quint
- Department of Dermatology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Christine Bangert
- Department of Dermatology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Julia Eckl-Dorna
- Department of Otorhinolaryngology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
| | - Sven Schneider
- Department of Otorhinolaryngology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
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Zum Einfluss von psychischen Komorbiditäten auf die Lebensqualität von Patienten mit einer chronischen Rhinosinusitis. HNO 2019; 67:534-541. [DOI: 10.1007/s00106-019-0658-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Stephenson ED, Farzal Z, Zanation AM, Senior BA. Sex bias in rhinology research. Int Forum Allergy Rhinol 2018; 8:1469-1475. [PMID: 30028087 DOI: 10.1002/alr.22179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 06/07/2018] [Accepted: 06/14/2018] [Indexed: 11/11/2022]
Abstract
BACKGROUND Analysis of general surgery literature has revealed noteworthy sex bias and underreporting. Our objective was to determine the prevalence of sex bias and underreporting in rhinology. METHODS All articles in 2016 issues of Rhinology, the American Journal of Rhinology and Allergy (AJRA), and the International Forum of Allergy and Rhinology (IFAR) were reviewed. Of 369 articles, 248 met inclusion criteria. Excluded studies were cadaveric, meta-analysis/review, and editorial. Data collected included study type, demographics, and sex-based statistical analysis. RESULTS There were 202 clinical and 46 basic science/translational studies. From 188 of 202 clinical studies with known sex, 1 included participants of a single sex. Sex matching >50% (SM50 ) was found in 81.9%, and 55.9% performed sex-based statistical analysis. Domestic clinical studies performed sex-based analysis more frequently than international (54.9% vs 44.4%) and exhibited a higher rate of SM50 (84.5% vs 80.3%), though these differences were not statistically significant. For basic/translational studies, 54.5% (24/44) provided sex breakdown. Among these, 29.2% included 1 sex, and 8.3% performed sex-based analysis. Of 10 using animals, 70.0% utilized 1 sex. The remaining 30.0% did not report sex. None of 4 cell line studies reported cell sex. Less than half (46.2%) of domestic and 56.3% of international studies reported sex breakdown; 7.7% of domestic and 3.0% of international studies performed sex-based analysis. CONCLUSION Although sex may impact outcomes, research without sex reporting and analysis is prevalent, particularly among basic science/translational studies. Future research must account for sex in demographics and analysis to best inform evidence-based clinical guidelines.
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Affiliation(s)
- Elizabeth D Stephenson
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Zainab Farzal
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Adam M Zanation
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Brent A Senior
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC
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6
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Nyaiteera V, Nakku D, Nakasagga E, Llovet E, Kakande E, Nakalema G, Byaruhanga R, Bajunirwe F. The burden of chronic rhinosinusitis and its effect on quality of life among patients re-attending an otolaryngology clinic in south western Uganda. BMC EAR, NOSE, AND THROAT DISORDERS 2018; 18:10. [PMID: 29983636 PMCID: PMC6019719 DOI: 10.1186/s12901-018-0058-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 06/18/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Worldwide, the burden of chronic rhinosinusitis (CRS) is variable, but not known in Uganda. CRS has significant negative impact on quality of life (QOL) and as such QOL scores should guide adjustments in treatment strategies. However, most of these studies have been done in the west. Our hypothesis was that QOL scores of the majority of CRS patients in low- to- middle income countries are poorer than those among patients without CRS. The aim of this study was to determine the burden of CRS among patients re-attending the Otolaryngology clinic and whether CRS is related to poor QOL. METHODS A cross sectional study was conducted at Mbarara Regional Referral Hospital Otolaryngology clinic. One hundred and twenty-six adult re-attendees were consecutively recruited. Data was collected using a structured questionnaire and the Sinonasal Outcome Test 22 (SNOT 22) questionnaire measured QOL. RESULTS The proportion of re-attendees with CRS was 39.0% (95% CI 30-48%). Majority of CRS patients had poor quality of life scores compared to non-CRS (88% versus 20% p < 01). The poor quality of life scores on the SNOT 22 were almost solely as a result of the functional, physical and psychological aspects unique to CRS. CONCLUSIONS CRS is highly prevalent among re-attendees of an Otolaryngology clinic at a hospital in resource limited settings and has a significant negative impact on the QOL of these patients.
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Affiliation(s)
- Victoria Nyaiteera
- Department of Ear, Nose and Throat, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Doreen Nakku
- Department of Ear, Nose and Throat, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Esther Nakasagga
- Department of Ear, Nose and Throat, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Evelyn Llovet
- Department of Ear, Nose and Throat, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Elijah Kakande
- Infectious Disease Research Collaboration, Mbarara, Uganda
| | - Gladys Nakalema
- Department of Psychology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Richard Byaruhanga
- Department of Ear, Nose and Throat, Makerere University College of Health Sciences, Kampala, Uganda
| | - Francis Bajunirwe
- Department of Community Health, Mbarara University of Science and Technology, Mbarara, Uganda
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7
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Ference EH, Tan BK, Hulse KE, Chandra RK, Smith SB, Kern RC, Conley DB, Smith SS. Commentary on gender differences in prevalence, treatment, and quality of life of patients with chronic rhinosinusitis. ALLERGY & RHINOLOGY 2015; 6:82-8. [PMID: 26302727 PMCID: PMC4541639 DOI: 10.2500/ar.2015.6.0120] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Objective: To examine the existing evidence on gender differences in the prevalence, treatment, and quality of life of patients with chronic rhinosinusitis (CRS). Methods: Review of the literature and expert opinion. Results: From a sociologic standpoint, women have historically been considered more likely to report symptoms, seek medical care, and give poorer self-evaluation of health, which may bias data toward increased prevalence and a greater effect of CRS on quality of life in women. However, the influence of gender seems to be restricted primarily to the evaluation of general quality of life, whereas the disease-specific health-related quality of life is not different between genders. Furthermore, migraine headaches, which are more common among women, may be misdiagnosed as CRS, which contributes to gender differences in the prevalence of CRS. The degree to which reported differences in prevalence and health utilization represent biologic or physiologic differences between genders is not known; however, differences in anatomic size, tobacco susceptibility, and hormonal factors have been speculated to increase the overall susceptibility to CRS in women compared with men. Conclusions: Focused research that examines the effect of gender on the development, treatment, and outcomes of CRS is warranted.
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Affiliation(s)
- Elisabeth H Ference
- Department of Otolaryngology - Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois,, USA
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8
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Lange B, Thilsing T, Baelum J, Pedersen OF, Holst R, Kjeldsen AD. Do patients with chronic rhinosinusitis benefit from consultation with an ENT-doctor? Acta Otolaryngol 2015; 135:706-12. [PMID: 25813521 DOI: 10.3109/00016489.2015.1019005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION By consulting an ENT-doctor, patients with chronic rhinosinusitis (CRS), in the general population, receive disease information and adjustment of treatment which can improve disease-specific Quality-of-Life and may improve objective measurements. OBJECTIVES This study aims to follow persons with clinical diagnosed CRS from the general population, to evaluate their benefit from consultation with an ENT-doctor in terms of severity of symptoms and Quality-of-Life. METHODS As part of a trans-European study, selected respondents to a survey questionnaire were invited for a clinical visit. Based on the European Position Paper on Rhinosinusitis and Nasal Polyps, persons were diagnosed with CRS and followed for 2 years. Quality-of-Life was measured using the Sino Nasal Outcome Test 22 and European Quality-of-Life - 5 Dimensions. Clinical examination included rhinoscopy, acoustic rhinometry, peak nasal inspiratory flow, smell test, and skin prick test. RESULTS Out of 91 persons with CRS, only 42% had previously consulted an ENT-doctor, and 51% were in current treatment for CRS. Most patients were advised medical treatment and 20% underwent surgery. Disease-specific Quality-of-Life, peak nasal inspiratory flow, olfactory function, and the nasal volume significantly increased over the 2-year period.
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Affiliation(s)
- Bibi Lange
- Department of Otorhinolaryngology, Odense University Hospital, University of Southern Denmark , Odense , Denmark
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Ference EH, Stubbs V, Lidder AK, Chandra RK, Conley D, Avila PC, Hirsch AG, Min JY, Smith SS, Kern RC, Tan BK. Measurement and comparison of health utility assessments in chronic rhinosinusitis. Int Forum Allergy Rhinol 2015; 5:929-36. [PMID: 26077390 DOI: 10.1002/alr.21556] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 04/08/2014] [Accepted: 04/21/2015] [Indexed: 12/18/2022]
Abstract
BACKGROUND Chronic rhinosinusitis (CRS) is a common condition encountered in primary care medicine and is estimated to affect 12.5% of the United States population. This study aims to compare methods of assessing health utility in CRS. METHODS A cross-sectional sample of CRS patients (n = 137) were interviewed using direct health utility assessment measures: the visual analogue scale (VAS), time trade-off (TTO), and standard gamble (SG). General quality of life (QOL) scores were obtained via the 36-item Short Form Health Survey (SF-36) and converted to SF-6D health utility values using a Bayesian algorithm. Disease-specific QOL was measured with the 22-item Sino-Nasal Outcome Test (SNOT-22). A selected subgroup of patients (n = 51) not initiating surgery or new treatment for CRS were re-interviewed within 3 weeks. RESULTS The mean ± SD health utilities were VAS 0.69 ± 0.19; TTO 0.80 ± 0.27; SG 0.93 ± 0.11; and SF-6D 0.72 ± 0.12; they differed significantly (p < 0.001). Only VAS scores differed based on disease state classification or the presence of nasal polyposis. Correlations between methods of determining health utility were weak, but significant. VAS, TTO, and SF-6D scores were significantly associated with SNOT-22 (p < 0.001 for all); however, SG and SNOT-22 were poorly correlated (Spearman correlation = -0.33). The test-retest reliability of TTO (Spearman correlation = 0.71) and SG (0.73) was strong. CONCLUSION CRS patients show significant impairment in QOL, with health utility values similar to those of patients with acquired immune deficiency syndrome (AIDS) or intermittent claudication using similar methods. The method of ascertainment significantly affects measured health utility, but the degree of impairment warrants improved recognition and appropriate treatment of the condition.
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Affiliation(s)
- Elisabeth H Ference
- Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Vanessa Stubbs
- Department of Otolaryngology-Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Alcina K Lidder
- School of Medicine and Dentistry, University of Rochester School of Medicine, Rochester, NY
| | - Rakesh K Chandra
- Department of Otolaryngology, Vanderbilt Bill Wilkerson Center, Nashville, TN
| | - David Conley
- Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Pedro C Avila
- Division of Allergy-Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | | | - Jin-Young Min
- Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Stephanie Shintani Smith
- Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL.,Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Robert C Kern
- Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Bruce K Tan
- Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL
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10
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Fu QL, Ma JX, Ou CQ, Guo C, Shen SQ, Xu G, Shi J. Influence of self-reported chronic rhinosinusitis on health-related quality of life: a population-based survey. PLoS One 2015; 10:e0126881. [PMID: 25978550 PMCID: PMC4433264 DOI: 10.1371/journal.pone.0126881] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 04/08/2015] [Indexed: 11/26/2022] Open
Abstract
Chronic rhinosinusitis (CRS) is a frequently occurring chronic respiratory disease. There is evidence that effective treatment of CRS can improve patients’ quality of life, but the data regarding the extent to which CRS impairs patients’ quality of life (QoL) is sparse. This study aimed to evaluate the effect of self-reported CRS on health-related QoL and to determine whether the influence was associated with gender, age and socio-economic status. A four-stage random sampling method was used to select the participants from the general population in Guangzhou, China. All participants were interviewed face-to-face at their homes using a standardized questionnaire. The health-related QoL of each participant was assessed using the SF-36 Health Survey. The scores of the SF-36 after adjusting for gender, age, socioeconomic conditions, smoking and some important comorbid conditions were compared between the CRS group and the non-CRS group using analysis of covariance. A multiple linear regression model with interaction terms was established to determine whether CRS affected QoL to the same degree across the different subpopulations. Among a total of 1,411 participants aged at least 15 years, 118 persons (8.4%) had self-reported CRS. Subjects with CRS had an increased prevalence of allergic rhinitis, chronic obstructive pulmonary disease and gout than subjects without CRS. The CRS group had lower scores in all eight domains and the physical and mental component summary than those without CRS (P<0.05), and the greatest differences were in role emotional function (RE), general health (GH) and role physical function (RP). The impairments of the CRS participants in RE and RP were greater among the females than the males. Moreover, physical domains were affected to greater degrees among the elderly and those with high-level education. In conclusion, CRS is a common chronic disorder. Persons with self-reported CRS perceived themselves as having impaired QoL in both the physical and mental domains. These findings shed new light on the health burden of CRS and should be taken into account by clinicians involved in the care of CRS patients.
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Affiliation(s)
- Qing-Ling Fu
- Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou, Guangdong, 510080, China
| | - Jin-Xiang Ma
- Department of Applied Statistics, School of Public Health, Guangzhou Medical University, Guangzhou, Guangdong, 511436, China
| | - Chun-Quan Ou
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China
- * E-mail: (CQO); (JS)
| | - Cui Guo
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Shuang-Quan Shen
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Geng Xu
- Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou, Guangdong, 510080, China
| | - Jianbo Shi
- Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou, Guangdong, 510080, China
- * E-mail: (CQO); (JS)
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11
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Remenschneider AK, D'Amico L, Gray ST, Holbrook EH, Gliklich RE, Metson R. The EQ-5D: A new tool for studying clinical outcomes in chronic rhinosinusitis. Laryngoscope 2014; 125:7-15. [DOI: 10.1002/lary.24715] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 03/05/2014] [Accepted: 03/26/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Aaron K. Remenschneider
- Department of Otolaryngology; Massachusetts Eye and Ear Infirmary
- Department of Otology and Laryngology; Harvard Medical School; Boston Massachusetts U.S.A
| | - Laura D'Amico
- Department of Otolaryngology; Massachusetts Eye and Ear Infirmary
| | - Stacey T. Gray
- Department of Otolaryngology; Massachusetts Eye and Ear Infirmary
- Department of Otology and Laryngology; Harvard Medical School; Boston Massachusetts U.S.A
| | - Eric H. Holbrook
- Department of Otolaryngology; Massachusetts Eye and Ear Infirmary
- Department of Otology and Laryngology; Harvard Medical School; Boston Massachusetts U.S.A
| | - Richard E. Gliklich
- Department of Otolaryngology; Massachusetts Eye and Ear Infirmary
- Department of Otology and Laryngology; Harvard Medical School; Boston Massachusetts U.S.A
| | - Ralph Metson
- Department of Otolaryngology; Massachusetts Eye and Ear Infirmary
- Department of Otology and Laryngology; Harvard Medical School; Boston Massachusetts U.S.A
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Remenschneider AK, D’Amico L, Litvack JR, Gray ST, Holbrook EH, Gliklich R, Metson R. Long-Term Outcomes in Sinus Surgery. Otolaryngol Head Neck Surg 2014; 151:164-70. [DOI: 10.1177/0194599814529536] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 03/07/2014] [Indexed: 11/16/2022]
Abstract
Objective The 6-question EuroQol 5-Dimension Health Assessment (EQ-5D) is a widely used, simple instrument that monitors general health-related quality of life (HRQoL) in chronic disease. It has not previously been applied to US patients undergoing endoscopic sinus surgery (ESS). Study Design Prospective cohort study. Setting Academic Medical Center. Subjects and Methods The study population consisted of 267 patients with chronic rhinosinusitis (CRS) who completed 2 disease-specific instruments—the Chronic Sinusitis Survey (CSS) and the Sinonasal Outcomes Test-22 (SNOT-22)—and 1 general health-related quality-of-life instrument—the EQ-5D—before and after ESS for CRS. Baseline scores were compared to those collected 3 and 12 months after surgery and to the general US population. Results Surveys were completed at all time points by 186 patients, for a response rate of 69.7%. Patients with CRS, when compared to the US population, reported more problems in the domains of pain/discomfort (73.1% vs 40.8%, P < .01), anxiety/depression (50.5% vs 26.4%, P < .01), and usual activities (30.6% vs 15.0%, P < .01). One year following ESS, there was a significant decrease in patients who reported problems with pain/discomfort (54.3%, P < .001), anxiety/depression (30.6%, P < .001), and usual activities (21.5%, P < .01). After surgery, CRS anxiety/depression scores were no different from those of the US general population. Chronic Sinusitis Survey and SNOT-22 scores demonstrated similar postoperative improvements. Conclusion The EQ-5D assessment provides meaningful general health outcomes data with low patient burden. Application of this instrument demonstrated long-term improvement in the quality of life of patients who undergo sinus surgery.
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Affiliation(s)
- Aaron K. Remenschneider
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
- Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA
| | - Laura D’Amico
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Jamie R. Litvack
- Department of Surgery, Washington Veterans Affairs Medical Center, Department of Otolaryngology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Stacey T. Gray
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
- Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA
| | - Eric H. Holbrook
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
- Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA
| | - Richard Gliklich
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
- Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA
| | - Ralph Metson
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
- Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA
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Mainz JG, Schien C, Schiller I, Schädlich K, Koitschev A, Koitschev C, Riethmüller J, Graepler-Mainka U, Wiedemann B, Beck JF. Sinonasal inhalation of dornase alfa administered by vibrating aerosol to cystic fibrosis patients: a double-blind placebo-controlled cross-over trial. J Cyst Fibros 2014; 13:461-70. [PMID: 24594542 DOI: 10.1016/j.jcf.2014.02.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 02/07/2014] [Accepted: 02/09/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Chronic rhinosinusitis significantly impairs CF patients' quality of life and overall health. The Pari-Sinus™ device delivers vibrating aerosol effectively to paranasal sinuses. After a small pilot study to assess sinonasal inhalation of dornase alfa and placebo (isotonic saline) on potential sinonasal outcome measures, we present the subsequent prospective double-blind placebo-controlled crossover-trial. METHODS 23 CF patients were randomised to inhale either dornase alfa or isotonic saline for 28 days with the Pari-Sinus™ and after 28 days (wash-out) crossed over to the alternative treatment. The primary outcome parameter was primary nasal symptom score in the disease-specific quality of life Sino-Nasal Outcome-Test-20 (SNOT-20: nasal obstruction/sneezing/runny nose/thick nasal discharge/reduced smelling). RESULTS Primary nasal symptoms improved significantly with dornase alfa compared with no treatment, while small improvements with isotonic saline did not reach significance. SNOT-20 overall scores improved significantly after dornase alfa compared with isotonic saline (p=0.017). Additionally, sinonasal dornase alfa but not isotonic saline significantly improved pulmonary function (FEF75-25: p=0.021). CONCLUSION Vibrating sinonasal inhalation of dornase alfa reduces rhinosinusitis symptoms in CF.
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Affiliation(s)
- Jochen G Mainz
- Department of Paediatrics, CF-Center, Jena University Hospital, Kochstraße 2, 07745 Jena, Germany.
| | - Claudia Schien
- Department of Paediatrics, CF-Center, Jena University Hospital, Kochstraße 2, 07745 Jena, Germany
| | - Isabella Schiller
- Department of Paediatrics, CF-Center, Jena University Hospital, Kochstraße 2, 07745 Jena, Germany
| | - Katja Schädlich
- Department of Paediatrics, CF-Center, Jena University Hospital, Kochstraße 2, 07745 Jena, Germany
| | - Assen Koitschev
- Department of Paediatric Otorhinolaryngology, Olgahospital, Stuttgart, Bismarckstraße 8, 70176 Stuttgart, Germany
| | - Christiane Koitschev
- Department of Otorhinolaryngology, University Hospital, Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany
| | - Joachim Riethmüller
- Department of Paediatrics, University Children's Hospital, Tübingen, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany
| | - Uta Graepler-Mainka
- Department of Paediatrics, University Children's Hospital, Tübingen, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany
| | - Bärbel Wiedemann
- Department of Medical Informatics and Biometrics, Technical University Dresden, Fetscherstr. 74, 01307 Dresden, Germany
| | - James F Beck
- Department of Paediatrics, CF-Center, Jena University Hospital, Kochstraße 2, 07745 Jena, Germany
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Cingi C, Eskiizmir G. Deviated nose attenuates the degree of patient satisfaction and quality of life in rhinoplasty: a prospective controlled study. Clin Otolaryngol 2013; 38:136-41. [PMID: 23406156 DOI: 10.1111/coa.12099] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To analyse and compare the patient satisfaction and quality of life in patients with and without deviated nose deformity who underwent rhinoplasty. DESIGN Prospective, before-after trial. SETTING Tertiary referral centre. PARTICIPANTS A total of 191 patients who underwent primary rhinoplasty between 2006 and 2009 were included. The study population was separated into two groups: non-deviated (patients with an external nasal deformity of less than 5(0)) and deviated nose (patients with an external nasal deformity of more than 5(0)). MAIN OUTCOME MEASURES The angles of deviations were measured from the pre- and postoperative photographs by an image analysis software program. Patient satisfaction and quality of life were measured by Rhinoplasty outcome evaluation and European Quality of Life-5 Dimension questionnaires before and after surgery. RESULTS Eighty-one cases had deviated nose deformity; on the other hand, 110 cases had nasal deformities other than deviated nose deformity. The objective analysis of surgical outcome demonstrated a statistically significant improvement in the favour of postoperative results in both non-deviated (P = 0.0004) and deviated (P = 0.0002) nose groups. In addition, Rhinoplasty outcome evaluation and European Quality of Life-5 Dimension questionnaires demonstrated remarkable improvement in both non-deviated and deviated nose groups after rhinoplasty. However, the comparison of pre- and postoperative change between non-deviated and deviated nose groups demonstrated statistically significant differences in almost all questions (except family and friends' satisfaction with appearance P = 0.069) and total score (P < 0.001) of Rhinoplasty outcome evaluation questionnaire, European Quality of Life-5 Dimension index (P < 0.001), European Quality of Life-5 Dimension visual analogue scale (P = 0.036) and living quality index (P < 0.001) with lower scores in deviated nose group. CONCLUSION Rhinoplasty can provide an objective improvement, high satisfaction and positive impact on quality of life. However, the degree of satisfaction and improvement in quality of life in patients with deviated nose deformity are less than patients with non-deviated nose deformity.
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Affiliation(s)
- C Cingi
- Department of Otolaryngology-Head Neck Surgery, Osmangazi University, Eskişehir, Turkey
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Ek A, Middelveld RJM, Bertilsson H, Bjerg A, Ekerljung L, Malinovschi A, Stjärne P, Larsson K, Dahlén SE, Janson C. Chronic rhinosinusitis in asthma is a negative predictor of quality of life: results from the Swedish GA(2)LEN survey. Allergy 2013; 68:1314-21. [PMID: 24107218 DOI: 10.1111/all.12222] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Asthma and chronic rhinosinusitis (CRS) both impair quality of life, but the quality-of-life impact of comorbid asthma and CRS is poorly known. The aim of this study was to evaluate the impact of CRS and other relevant factors on quality of life in asthmatic subjects. METHODS This Swedish cohort (age 17-76 years) consists of 605 well-characterized asthmatics with and without CRS, 110 individuals with CRS only, and 226 controls and is part of the Global Allergy and Asthma European Network (GA(2) LEN) survey. The Mini Asthma Quality of Life Questionnaire (mAQLQ), the Euro Quality of Life (EQ-5D) health questionnaire, spirometry, skin prick test (SPT), exhaled nitric oxide (FeNO), smell test, and peak nasal inspiratory flow were used. RESULTS Subjects having both asthma and CRS have lower mAQLQ scores in all domains (P < 0.001) and a lower EQ-5D index value and EQ-5D VAS value (P < 0.001) compared to those with asthma only. Asthmatics with CRS have significantly lower FEV1%pred and FVC%pred (88.4 [85.1-91.7] and 99.9 [96.7-103.0], respectively) compared with asthma only (91.9 [90.3-93.4] and 104.0 [102.5-105.5], respectively P < 0.05). Multiple regression analysis shows that low asthma quality of life is associated with having CRS (P < 0.0001), lower lung function (P = 0.008), current smoking (P = 0.01), BMI > 30 kg/m2 (P = 0.04), high age (P = 0.03), and a negative SPT (P = 0.04). CONCLUSIONS Comorbid CRS was a significant and independent negative predictor of quality of life in asthmatics. Other negative factors were lower lung function, current smoking, obesity, advanced age, and having nonatopic asthma.
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Affiliation(s)
- A. Ek
- Experimental Asthma and Allergy Research Unit; Institute of Environmental Medicine; Karolinska Institutet; Stockholm; Sweden
| | - R. J. M. Middelveld
- The Centre for Allergy Research and Institute of Environmental Medicine; Karolinska Institutet; Stockholm; Sweden
| | - H. Bertilsson
- Department of Public Health and Clinical Medicine: Occupational and Environmental Medicine; Umeå University; Umeå; Sweden
| | - A. Bjerg
- Krefting Research Centre; Department of Internal Medicine and Clinical Nutrition; Sahlgrenska Academy; University of Gothenburg; Göteborg; Sweden
| | - L. Ekerljung
- Krefting Research Centre; Department of Internal Medicine and Clinical Nutrition; Sahlgrenska Academy; University of Gothenburg; Göteborg; Sweden
| | - A. Malinovschi
- Department of Medical Sciences: Clinical Physiology; Uppsala University; Uppsala; Sweden
| | - P. Stjärne
- Department of Clinical Science; Intervention and Technology: Otorhinolaryngology; Karolinska Institutet; Stockholm; Sweden
| | - K. Larsson
- Lung and Allergy Research Unit; Institute of Environmental Medicine; Karolinska Institutet; Stockholm; Sweden
| | - S.-E. Dahlén
- Experimental Asthma and Allergy Research Unit; Institute of Environmental Medicine; Karolinska Institutet; Stockholm; Sweden
| | - C. Janson
- Department of Medical Sciences: Respiratory Medicine and Allergology; Uppsala University; Uppsala; Sweden
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Cingi C, Eskiizmir G, Cakli H. Comparative analysis of primary and secondary rhinoplasties according to surgeon's perspective, patient satisfaction, and quality of life. Ann Otol Rhinol Laryngol 2012; 121:322-7. [PMID: 22724278 DOI: 10.1177/000348941212100507] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES We sought to analyze and compare the problems and technical difficulties related to surgical intervention, patient satisfaction, and quality of life after primary and secondary rhinoplasties. METHODS A total of 168 cases of rhinoplasty were grouped as primary or secondary according to the patient's history of rhinoplasty. The type of nasal deformity, the surgical approach, and the difficulty of the surgery were recorded. The levels of patient satisfaction and the quality of life were assessed before and after the operation with the Rhinoplasty Outcomes Evaluation (ROE) and European Quality of Life-5 Dimension (EQ-5D) questionnaires. A quantitative and statistical analysis was performed. RESULTS Thirty-three patients had secondary rhinoplasty, and 135 patients had primary rhinoplasty. Relatively high rates of saddle nose deformity, crooked nose, and tip asymmetry were observed in the secondary rhinoplasty group. The preoperative and postoperative scores on the ROE and EQ-5D questionnaires demonstrated statistically significant differences in both the primary and secondary rhinoplasty groups. The comparison of postoperative change between the primary and secondary rhinoplasty groups did not demonstrate a statistically significant difference. CONCLUSIONS The surgical difficulty of secondary rhinoplasty is approximately twice that of primary rhinoplasty because of the high rate of major deformities. However, the levels of patient satisfaction and improvements in quality of life are similar after primary and secondary rhinoplasties.
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Affiliation(s)
- Cemal Cingi
- Department of Otolaryngology-Head Neck Surgery, Osmangazi University, Eskilehir, Turkey
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Mainz JG, Schiller I, Ritschel C, Mentzel HJ, Riethmüller J, Koitschev A, Schneider G, Beck JF, Wiedemann B. Sinonasal inhalation of dornase alfa in CF: A double-blind placebo-controlled cross-over pilot trial. Auris Nasus Larynx 2011; 38:220-7. [DOI: 10.1016/j.anl.2010.09.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2009] [Revised: 09/21/2010] [Accepted: 09/21/2010] [Indexed: 10/18/2022]
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Baumann I. Validierte Lebensqualitätsmessinstrumente zur Anwendung bei Patienten mit chronischer Rhinosinusitis. HNO 2009; 57:873-81. [DOI: 10.1007/s00106-009-1972-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Chester AC, Sindwani R, Smith TL, Bhattacharyya N. Systematic review of change in bodily pain after sinus surgery. Otolaryngol Head Neck Surg 2009; 139:759-65. [PMID: 19041499 DOI: 10.1016/j.otohns.2008.09.020] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2008] [Revised: 09/15/2008] [Accepted: 09/17/2008] [Indexed: 11/19/2022]
Abstract
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.
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Affiliation(s)
- Alexander C Chester
- Department of Medicine, Georgetown University Hospital, Washington, DC 20016, USA.
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Baumann I, Plinkert PK, De Maddalena H. [Development of a grading scale for the Sino-Nasal Outcome Test-20 German Adapted Version (SNOT-20 GAV)]. HNO 2008; 56:784-8. [PMID: 17874055 DOI: 10.1007/s00106-007-1606-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Quality of life measurements with the Sino-Nasal Outcome Test-20 German Adapted Version (SNOT-20 GAV) in chronic rhinosinusitis (CRS) patients require normative values measured in a comparison group taken from the normal population. These will make it possible to reach conclusions on correlations between scores and severity of symptoms and also on how close such patients' scores can get to those scores recorded in healthy subjects after surgical treatment. PATIENTS AND METHODS We collected SNOT-20 GAV data and data on the presence of CRS from 778 subjects via a web-based survey of employees of the University Hospital in Heidelberg. For comparison we used data collected before surgery and at 3 months and 1 year after surgery from 163 CRS patients who had undergone endonasal sinus surgery (ESS). RESULTS Gender and age had no clinically significant impact on the SNOT-20 GAV scores. We defined an assessment scale with four classes of symptom intensity. Surgically treated patients with CRS showed a persisting small disadvantage in the scales of the SNOT-20 GAV compared with the reference subgroup without CRS. When surgically treated CRS patients were compared with the entire reference group these disadvantages were only obvious in the Primary Nasal Symptoms (PNS) scale and not in the other scales measuring quality of life. CONCLUSION Patients with CRS benefit from ESS and subsequently reach scores similar to those recorded in the reference group. The newly developed four-level assessment scale is easy to use and gives the attending physician additional information about the severity of the patients' illness and its effects on their subjective wellbeing.
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Affiliation(s)
- I Baumann
- Universitäts-HNO-Klinik, Im Neuenheimer Feld 400, 69120 Heidelberg.
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Alobid I, Bernal-Sprekelsen M, Mullol J. Chronic rhinosinusitis and nasal polyps: the role of generic and specific questionnaires on assessing its impact on patient's quality of life. Allergy 2008; 63:1267-79. [PMID: 18782106 DOI: 10.1111/j.1398-9995.2008.01828.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Chronic rhinosinusitis (CRS) including nasal polyps is a chronic inflammatory disease of the nasal and paranasal sinus mucosa that, despite differing hypotheses of its cause, remains poorly understood. Primary symptoms are nasal blockage, loss of smell, rhinorrhea, and facial pain or pressure. Chronic rhinosinusitis causes significant physical symptoms, has a negative impact on quality of life (QoL), and can substantially impair daily functioning. A global evaluation of patients must include, together with nasal symptoms, nasal endoscopy, and CT scan, the measurement of QoL. To assess QoL in CRS, specific and generic questionnaires may be used. Chronic rhinosinusitis has a considerable impact on a patient's QoL but comorbidities, such as asthma and atopy, have an accumulative negative effect. Both medical and surgical treatments lead to a similar improvement on the QoL of CRS and nasal polyp patients.
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Affiliation(s)
- I Alobid
- Rhinology Unit and Smell Clinic, Department of Otorhinolaryngology, Hospital Clínic i Universitari, Barcelona, Spain
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Fatigue improvement following endoscopic sinus surgery: a systematic review and meta-analysis. Laryngoscope 2008; 118:730-9. [PMID: 18216743 DOI: 10.1097/mlg.0b013e318161e57b] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Fatigue is a common symptom of chronic rhinosinusitis (CRS), yet the response of fatigue to endoscopic sinus surgery (ESS) has not been systematically evaluated. METHODS Studies published in any language were retrieved by searching MEDLINE, EMBASE, Web of Science, Cochrane databases, and additional Web-based sources (from 1980-2007); by examining bibliographies of retrieved articles; and by contacting investigators in the field. Studies consisting of more than 10 adult patients analyzing the response of fatigue, vitality, energy, or malaise following ESS were included. Two authors independently evaluated studies for inclusion, rated the methods, and summarized relevant data using a standardized protocol. RESULTS Using within-subject comparisons, 28 identified observational studies noted substantial improvement in fatigue after ESS. A subgroup analysis of 11 studies measuring outcomes using the 36-Item Short Form Health Survey (SF-36) demonstrated a moderate-sized combined effect of 0.47 (95% confidence interval, 0.38-0.56; I = 0%), corresponding to a mean +/- standard deviation improvement of 9.7 +/- 3.4 units on the SF-36 vitality domain scores. In studies measuring outcomes using symptom rating scores, the preoperative severity scores and improvement after surgery for fatigue were similar to the respective values for other pooled CRS symptoms. CONCLUSIONS All 28 studies described substantial improvement in fatigue following ESS based on presurgery and postsurgery comparisons. A subgroup analysis of 11 studies reporting results by the SF-36 vitality domain scores demonstrated a moderate-sized combined effect. Preoperative fatigue severity scores and improvement noted after surgery were similar to the respective values for other pooled CRS symptoms.
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Impact of gender on clinical presentation of chronic rhinosinusitis with and without polyposis. The Journal of Laryngology & Otology 2008; 122:1180-4. [PMID: 18184447 DOI: 10.1017/s0022215107001302] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
STUDY OBJECTIVE To determine the impact of a patient's gender on the clinical presentation of chronic rhinosinusitis with and without nasal polyposis. STUDY DESIGN AND METHODS Prospective study of 514 adult patients who presented with chronic rhinosinusitis with and without nasal polyposis. The patients were divided into two groups based on gender: female (n = 273) and male (n = 241). The following data were collected: presenting symptoms, co-morbidities, nasal endoscopy and sinus computed tomography findings, diagnosis, and outcome of surgery. Statistical analysis was performed using the chi-square test, with statistical significance set at p < 0.05. RESULTS Facial pain and headache were more prevalent among women, while nasal obstruction was more prevalent among men (p < 0.05). There was no statistically significant difference in the prevalence of environmental allergy, asthma, psychiatric illness or anatomical variants obstructing the osteomeatal unit, comparing the genders. Chronic rhinosinusitis without polyposis was the more common diagnosis among women, while chronic rhinosinusitis with polyposis was the more common diagnosis among men (p < 0.05). Following surgery, a higher percentage of male patients reported improvement in nasal obstruction (p < 0.05), but there was no statistically significant difference in the improvement of the other presenting symptoms, comparing the genders. CONCLUSION Women who suffer from chronic rhinosinusitis are more likely to complain of facial pain or headache on presentation and to be diagnosed with chronic rhinosinusitis without polyposis. On the other hand, men are more likely to complain of nasal obstruction, to be diagnosed with chronic rhinosinusitis with polyposis, and to report improvement in nasal obstruction following surgery.
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