Endoscopic Management of Chronic Frontal Sinusitis: Prospective Quality of Life Analysis

Ann Otol Rhinol Laryngol. 2015 Aug;124(8):638-48. doi: 10.1177/0003489415573959. Epub 2015 Mar 3.

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.

Keywords: chronic rhinosinusitis; endoscopic frontal sinusotomy; frontal sinus ostium patency; quality of life; rhinosinusitis disability index.

MeSH terms

  • Adult
  • Affective Symptoms / physiopathology
  • Chronic Disease
  • Disability Evaluation
  • Endoscopy* / adverse effects
  • Endoscopy* / methods
  • Female
  • Frontal Sinus* / diagnostic imaging
  • Frontal Sinus* / surgery
  • Frontal Sinusitis* / diagnosis
  • Frontal Sinusitis* / physiopathology
  • Frontal Sinusitis* / psychology
  • Frontal Sinusitis* / surgery
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications* / diagnosis
  • Postoperative Complications* / psychology
  • Prospective Studies
  • Quality of Life*
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome
  • United States