Response to medical or surgical therapy in chronic rhinosinusitis: A one year prospective analysis.
BACKGROUND
Chronic rhinosinusitis (CRS) is treated with both surgical and medication options. However, long term data on patient outcomes is rare. In a real world clinical environment, our objective was to identify CRS patients, gather patient characteristics, and follow symptoms over one year.


METHODS
This observational study enrolled patients with CRS, primary clinical makers included atopy testing, serum lgE, and complete blood counts. A sinus computerized tomography (CT) scan was performed serially. Patients were enrolled into medical treatment Arm A and into surgical treatment Arm B. Symptom scores were calculated using the chronic sinusitis survey (CSS).


RESULTS
Atopy testing was positive in 67%. lgE levels or atopy did not correlate with CSS scores A 23% decrease in total CSS scores was noted in Arm A at one year (p =.01). Arm B demonstrated a 38% reduction in total CSS scores at 3 months (p =.02) only. CT evidence of CRS was found in 74% of patients. However, CT scores did not change significantly over 12 months.


CONCLUSIONS
No correlation was found between serum lgE levels or atopy versus CSS scores. CT scan scores did not change significantly over 12 months in either treatment group. A reduction of CSS scores was seen in both treatment groups: however a rebound effect was suggest in the surgical arm. Our study demonstrates the disconnection common clinical setting. It exemplifies the need for controlled studies with years of chronic rhinosinusitis outcome analysis.
UCLA Signal Hill, CA, United States. docrandhawa@yahoo.com
I
I
Randhawa
L
L
Hiyama
A
A
Rafi
M
M
Wang
W
W
Klaustermeyer
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D002908:Chronic Disease; D018450:Disease Progression; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D008875:Middle Aged; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology* / Q000601:surgery; D011446:Prospective Studies; D012220:Rhinitis / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D012852:Sinusitis / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D012882:Skin Tests; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D007073:Immunoglobulin E