title: Histopathological inflammation and symptom outcomes after endoscopic sinus surgery.
abstract: BACKGROUND
  To determine if histopathology of the sinus mucosa predicts symptomatic outcomes after endoscopic sinus surgery (ESS).
  
  
  METHODS
  The histopathology of the sinus mucosa and preoperative and postoperative symptom scores from the Rhinosinusitis Symptom Inventory (RSI) for adults undergoing ESS for chronic rhinosinusitis (CRS) without polyposis were reviewed. Linear regression analysis was conducted to examine the relationship between tissue pathology inflammatory severity score and the postoperative RSI symptom scores, adjusting for baseline RSI scores, Lund score, postoperative topical steroid, antihistamine, and antibiotic use.
  
  
  RESULTS
  A total of 112 patients were enrolled (average age, 41.2 years; 68.8% female) with a follow-up of 19.1 ± 8.7 months (mean ± standard deviation [SD]). Mean preoperative and postoperative RSI domain scores for nasal symptoms and total symptoms were (52.4, 21.4) and (41.2, 17.7), respectively (p < 0.001). Topical steroid utilization increased from 15.3 to 20.7 weeks (p = 0.086) whereas antihistamine use and antibiotic use decreased by 1.4 and 1.6 weeks, respectively (p = 0.594 and 0.092). Pathology severity score did not significantly predict postoperative symptom scores on any of the RSI symptom domains nor the total symptom score (all p > 0.05).
  
  
  CONCLUSIONS
  Although pathologic inflammation of the paranasal sinuses is inherent to CRS, increasing pathology severity at ESS does not predict poorer symptomatic outcomes after ESS.
authors.affiliation: Division of Otolaryngology, Brigham and Women's Hospital, Boston, MA, USA. neiloy@massmed.org
authors.forename: Neil
authors.initials: N
authors.lastname: Bhattacharyya
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002908:Chronic Disease; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006633:Histamine Antagonists / Q000627:therapeutic use; D006801:Humans; D008297:Male; D011182:Postoperative Care; D011300:Preoperative Care; D012189:Retrospective Studies; D012220:Rhinitis / Q000188:drug therapy / Q000601:surgery*; D012720:Severity of Illness Index; D012852:Sinusitis / Q000188:drug therapy / Q000601:surgery*; D013256:Steroids / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D006633:Histamine Antagonists; D013256:Steroids