What is the optimal outcome after endoscopic sinus surgery in the treatment of chronic rhinosinusitis? A consultation of Canadian experts

Journal of Otolaryngology - Head & Neck Surgery - Tập 50 - Trang 1-10 - 2021
Nadim Saydy1, Sami P. Moubayed2, Marie Bussières3, Arif Janjua4, Shaun Kilty5, François Lavigne1, Eric Monteiro6, Smriti Nayan7, Marilou Piché8, Kristine Smith9, Doron Sommer7, Leigh Sowerby10, Marc A. Tewfik11, Ian J. Witterick6, Erin Wright12, Martin Desrosiers1
1Division of Otolaryngology – Head & Neck Surgery, Centre Hospitalier de l’Université de Montréal, Université de Montréal, Montreal, Canada
2Division of Otolaryngology – Head & Neck Surgery, Maisonneuve-Rosemont Hospital, Université de Montréal, Montreal, Canada
3Division of Otolaryngology – Head & Neck Surgery, Centre Hospitalier de l’Université de Sherbrooke – Hôtel-Dieu Hospital, University of Sherbrooke, Quebec, Canada
4Division of Otolaryngology – Head & Neck Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, Canada
5Division of Otolaryngology – Head & Neck Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, Canada
6Division of Otolaryngology – Head & Neck Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Canada
7Division of Otolaryngology – Head & Neck Surgery, Cambridge Memorial Hospital, McMaster University, Hamilton, Canada
8Division of Otolaryngology – Head & Neck Surgery, Hôpital Saint-Sacrement, Laval University, Quebec, Canada
9Division of Otolaryngology – Head & Neck Surgery, Winnipeg Health Sciences Center, University of Manitoba, Winnipeg, Canada
10Division of Otolaryngology – Head & Neck Surgery, St-Joseph’s Hospital, Western University, London, Canada
11Division of Otolaryngology – Head & Neck Surgery, Jewish General Hospital, McGill University, Montreal, Canada
12Division of Otolaryngology – Head & Neck Surgery, Walter C MacKenzie Health Sciences Center, University of Alberta, Edmonton, Canada

Tóm tắt

Many experts feel that in the absence of well-defined goals for success, they have an easier time identifying failure. As success ought to not be defined only by absence of failure, we aimed to define optimal outcomes for endoscopic sinus surgery (ESS) in chronic rhinosinusitis (CRS) by obtaining expert surgeon perspectives. A total of 12 surgeons participated in this targeted consultation. Face to face semi-structured interviews were performed with expert surgeons in the field of CRS and ESS. General impressions and personal definitions of acceptable operative success and optimal operative outcomes were compiled and summarized. According to an expert survey, patients’ main objectives are an improvement in their chief complain, a general improvement in quality of life (QoL), and a better overall symptomatic control. The most important aspects of endoscopy for defining a successful intervention were an adequate mucus circulation, a healthy mucosa, minimal edema, and patency of all explored cavities or ostia. In the assessment of surgical outcomes, it was determined that both objective and patient reported data must be carefully examined, with more attention given to subjective outcomes. According to data gathered from a Canadian expert consultation, a definition of success must be based on both subjective data and nasal endoscopy. We propose to define an acceptable outcome as either a subjective improvement of at least the minimal clinically improvement difference of a validated patient reported outcome questionnaire, along with a satisfactory endoscopic result (1) or a complete subjective resolution with a sub-optimal endoscopy (2).

Tài liệu tham khảo

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Journal of Otolaryngology - Head & Neck Surgery

Tập 50

1-10

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