Recurrent acute rhinosinusitis: presentation and outcomes of sinus surgery.
BACKGROUND
Patients with recurrent acute rhinosinusitis (RARS) represent a challenging subset of patients with rhinosinusitis. Data regarding the outcomes of care for these patients is extremely limited. The purpose of this study was to evaluate objective and patient-based measures in patients diagnosed with RARS before and after surgical intervention.


METHODS
A prospective, nested case-control study was performed. Cases of RARS (n = 22) were matched to patients with chronic rhinosinusitis (CRS) without polyposis (n = 22) by age, sex, and race/ethnicity. Preoperative computed tomography (CT) and pre- and postoperative endoscopic examinations, the Chronic Sinusitis Survey, and the Rhinosinusitis Disability Index were scored and compared between cases and controls.


RESULTS
Patients with RARS were less likely to have asthma or previous sinus surgery. Patients with CRS underwent more extensive surgery. There were no significant differences in preoperative CT, endoscopy, or patient-based, quality-of-life (QOL) scores. Both groups showed statistically significant improvements in total postoperative QOL scores. Patients with CRS showed significant improvement on endoscopy scores. Patients with RARS used significantly fewer sinus medications after endoscopic sinus surgery.


CONCLUSIONS
Patients with RARS were more often primary surgical patients and underwent less extensive surgery than their CRS counterparts. Both groups reported improved QOL after surgery.
Poetker
David M
DM
Division of Rhinology and Sinus Surgery, Oregon Sinus Center, Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon.
Litvack
Jamie R
JR
Mace
Jess C
JC
Smith
Timothy L
TL
D000208:Acute Disease; D000328:Adult; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011788:Quality of Life; D012008:Recurrence; D012220:Rhinitis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D012720:Severity of Illness Index; D012852:Sinusitis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome