Outcome in patients with chronic sinusitis after the minimally invasive sinus technique.
BACKGROUND
Controversy persists regarding the use of minimally invasive sinus techniques (MIST) to treat chronic sinusiris primarily because of an absence of comparative outcome data.


METHODS
In this prospective study of 85 patients with chronic sinusitis treated surgically with MIST, the long-term postoperative outcome was assessed using the duration-based Chronic Sinusitis Survey (CSS) quality of life instrument. Patient age ranged from 4 to 81 years old (mean age, 42 +/- 16.7 years). Forty-three subjects were male patients and 42 were female patients. Mean follow-up time was 23.8 +/- 2.2 months.


RESULTS
At follow-up, there was a 124.0% improvement in the mean CSS symptom score (p < 0.00001), a 30.1% improvement in the mean CSS medication score (p < 0.00001), and a 62.0% improvement in the mean CSS total score (p < 0.00001). An overall improvement was found in 78.8% of patients; 12.9% of patients were worse and 8.2% of patients were unchanged. Thirty-four patients (40.0%) had postsurgical CSS total scores within the normative interquartile range obtained in healthy controls. Twenty-six of these patients had postsurgical scores that actually surpassed the mean normative CSS total score. Before follow-up evaluation, 5 of the 85 patients (5.9%) had revision surgery after the initial procedure. All had revision MIST procedures and all were found to have an overall improvement at the time of follow-up.


CONCLUSIONS
We conclude that MIST significantly improves the outcome in patients with chronic sinusitis and should strongly be considered as the initial surgical option for such patients.
Catalano
Peter
P
Department of Otolaryngology Head and Neck Surgery, Lahey Clinic, Burlington, Massachusetts, USA.
Roffman
Eric
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009296:Nasal Cavity / Q000000981:diagnostic imaging / Q000601:surgery; D009298:Nasal Polyps / Q000175:diagnosis / Q000601:surgery; D011446:Prospective Studies; D011788:Quality of Life; D012086:Reoperation; D012720:Severity of Illness Index; D012852:Sinusitis / Q000175:diagnosis / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome