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

Laryngoscope. 2011 Dec;121(12):2679-83. doi: 10.1002/lary.22361. Epub 2011 Oct 27.

Abstract

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.

Trial registration: ClinicalTrials.gov NCT00799097.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Chronic Disease
  • Cohort Studies
  • Endoscopy / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Intraoperative Care / methods
  • Male
  • Middle Aged
  • Nasal Septum / surgery*
  • Paranasal Sinus Diseases / diagnosis
  • Paranasal Sinus Diseases / surgery*
  • Prospective Studies
  • Quality of Life*
  • Rhinitis / diagnosis
  • Rhinitis / surgery*
  • Risk Assessment
  • Sinusitis / diagnosis
  • Sinusitis / surgery*
  • Treatment Outcome
  • Young Adult

Associated data

  • ClinicalTrials.gov/NCT00799097