Endoscopic Management of Chronic Frontal Sinusitis: Prospective Quality of Life Analysis. (August 2015)

• Record Type: Journal Article
• Authors: Askar, Mohamed H.; Gamea, Ahmed; Tomoum, Mohamed O.; Elsherif, Hossam S.; Ebert, Charles; Senior, Brent A.
• Is Part Of: Annals of otology, rhinology & laryngology. Volume 124:Number 8(2015:Aug.)
• Page Start: 638
• Page End: 648
• Publication Date: 2015-08
• Subjects: chronic rhinosinusitis -- endoscopic frontal sinusotomy -- frontal sinus ostium patency -- quality of life -- rhinosinusitis disability index; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0003489415573959
• Languages: English
• ISSNs: 0003-4894

Abstract

Background: Previous studies of endoscopic frontal sinus surgery have been primarily retrospective and focused on symptom relief only. Objectives: To prospectively assess the impact of endoscopic frontal sinus surgery on frontal sinus ostium patency and disease-specific quality of life as measured by the Rhinosinusitis Disability Index (RSDI). Study Design: A 60-patient cohort with chronic frontal sinusitis (100 diseased frontal sinuses) was prospectively evaluated using the RSDI, computed tomography (CT) imaging, and endoscopic examination. Image-guided endoscopic frontal sinusotomy (Draf 2a) was performed in each case. Patients were assessed with RSDI and endoscopic assessment at least 6 months postoperatively. Results: At a mean follow-up of 10 months, endoscopic assessment revealed patent frontal recesses in 90 of 100 frontal sinuses (90%), with significant improvement in the total RSDI score (41.98 ± 26.48 preoperatively to 17.15 ± 15.66 postoperatively) as well as each of its physical, emotional, and functional subscales from 16.3 ± 9.03, 12.23 ± 10.55, 13.45 ± 9.59 preoperatively to 5.95 ± 5.71, 5.55 ± 5.66, 5.65 ± 5.72 postoperatively, respectively. Similar improvement was seen in patients with asthma, polyps, and those undergoing revision sinus surgeries. Conclusions: With frontal recess mucosal preservation and meticulous postoperative endoscopic surveillance, endoscopic frontal sinusotomy results in high rates of frontal sinus ostium patency with significant improvement in quality of life.