Objective testing and quality-of-life evaluation in surgical candidates with chronic rhinosinusitis.
BACKGROUND
Discordance has been reported between patient symptoms and objective measures of disease in chronic sinusitis, such as radiographic evaluation. The objective of this study was to evaluate the association between presurgical objective studies and presurgical quality of life (QOL). This work was designed as a cross-sectional study of 90 consecutive patients presenting to a tertiary rhinology practice for surgical management of sinonasal disease.


METHODS
QOL assessment was performed using disease-specific instruments (Chronic Sinusitis Survey and Rhinosinusitis Disability Index). Computed tomography (CT) scans were scored according to the Lund-Mackay CT scoring system and endoscopy evaluation was scored by the system proposed by Lund and Kennedy.


RESULTS
Ninety surgical candidates were enrolled and included in the analysis. Correlation between the QOL total scores and subscale scores was excellent (r = 0.39; p = 0.0001) as was the correlation between CT and endoscopy scores (r = 0.59; p = 0.0001). In contrast, correlation between QOL and objective measures was poor. These results were not significantly influenced by subgroup analysis by diagnosis, comorbidity, and other patient factors.


CONCLUSIONS
Preoperative objective measures of CRS disease show little, if any, correlation with disease-specific QOL measures in surgical candidates. It is likely that CT and endoscopy are measuring a different aspect of CRS disease than the QOL measures. In addition, it is possible that preoperative QOL, either alone or in combination with CT and endoscopy, may prove important in selecting patients most likely to benefit from surgery.
Smith
Timothy L
TL
Department of Otolaryngology and Communication Sciences, MCW Center for Patient Care and Outcomes Research, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA.
Rhee
John S
JS
Loehrl
Todd A
TA
Burzynski
Mary L
ML
Laud
Prakash W
PW
Nattinger
Ann B
AB
D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging; D011788:Quality of Life; D012220:Rhinitis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D012852:Sinusitis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed