The effect of endoscopic sinus surgery on quality of life and absenteeism in patients with chronic rhinosinuitis - a multi-centre study

Background: Chronic rhinosinusitis with and without nasal polyps (CRSw/sNP) are common conditions decreasing health-related quality of life (HRQOL).Individual symptoms capable of predicting outcome after endoscopic sinus surgery (ESS) are poorly defined, and the indirect costs of CRS is rarely reported in Europe.Methodology: Patients with CRSw/sNP admitted for ESS were prospectively enrolled.Patients completed the 22 Sinonasal Outcome Test (SNOT-22), the short-form 36-item questionnaire (SF-36), a Visual Analogue Scale (VAS) and reported CRS-related absenteeism pre-and post-operatively.Results: 181 patients were included.The SNOT-22 score diminished from 51.8 (48.7-55.0)pre-operatively to 33.0 (29.2-36.8)at 6 months.64% achieved a clinically important improvement in the SNOT-22.SF-36 scores improved statistically significantly in all domains except "Role Emotional".The VAS score halved from 68 (65-71) to 34 (29-39) at 6 months post-operatively.A pre-operative SNOT-22 score >20 implied a greater chance of score improvement after 6 months.A multivariate model identified individual items associated with SNOT-22.Further, patients that had <12 months of sinus disease derived greatest benefit.CRS-related absenteeism dropped from 8-14 days to 1-7 days 12 months after ESS.Conclusions: This prospective study showed that ESS significantly improved the HRQOL and decreased absenteeism of patients with CRSw/sNP.Shorter duration of disease and "Need to blow nose" and "Blockage/congestion of nose" of SNOT-22 were identified as predictive factors for good surgical outcome.