title: Impact of mucosal eosinophilia and nasal polyposis on quality-of-life outcomes after sinus surgery.
abstract: OBJECTIVE
  Assess whether the presence of mucosal eosinophilia correlates with surgical outcomes in patients with chronic rhinosinusitis.
  
  
  METHODS
  Prospective cohort.
  
  
  METHODS
  Tertiary medical center.
  
  
  METHODS
  Adult patients with chronic rhinosinusitis were prospectively enrolled, and demographic data and medical comorbidities were recorded. Preoperative quality of life (QOL) was measured by the Chronic Sinusitis Survey (CSS), Rhinosinusitis Disability Index (RSDI), and Short Form-36 General Health Survey (SF-36). Sinus mucosal specimens were collected at the time of surgery and the degree of eosinophilia quantified. Postoperative QOL was measured, and differences in QOL improvement were compared between those with and without eosinophilia.
  
  
  RESULTS
  A total of 102 patients had both histopathological and QOL outcome data available for review. Follow-up averaged 16.5 months. Patients with eosinophilia showed significantly less improvement in the RSDI total (17.9 vs 25.0; P = 0.044), RSDI functional (5.7 vs 8.8; general health subscale; P = 0.018), CSS medication (3.6 vs 17.3; P = 0.013), SF-36 general health (0.6 vs 9.6; P = 0.008), SF-36 physical role (16.1 vs 34.7; P = 0.036), and SF-36 vitality (11.9 vs 21.2; P = 0.034) scales than those without eosinophilia. The greatest improvement in QOL was seen in patients without eosinophilia or polyps, with the least improvement seen in those with eosinophilia but without polyps.
  
  
  CONCLUSIONS
  The presence of mucosal eosinophilia at the time of surgery consistently predicted less improvement in both disease-specific and general QOL compared with patients without eosinophilia. The impact of eosinophilia on outcomes was greatest for patients without nasal polyposis, a group that demonstrated the least improvement in QOL measures.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Oregon Sinus Center, Portland, OR, USA.
authors.forename: Zachary M
authors.initials: ZM
authors.lastname: Soler
authors.forename: David
authors.initials: D
authors.lastname: Sauer
authors.forename: Jess
authors.initials: J
authors.lastname: Mace
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004802:Eosinophilia / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa; D009298:Nasal Polyps / Q000150:complications*; D011446:Prospective Studies; D011788:Quality of Life; D012220:Rhinitis / Q000150:complications* / Q000601:surgery*; D012852:Sinusitis / Q000150:complications* / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult