title: Novel endoscopic scoring system after sinus surgery.
abstract: OBJECTIVE
  To propose a simple post-operative endoscopic scoring system for use after endoscopic sinus surgery (ESS) in patients with chronic rhinosinusitis (CRS), and to demonstrate the usefulness of this approach.
  
  
  METHODS
  Subjects comprised 116 patients (84 men, 32 women; mean age, 54 years) with CRS who were analyzed endoscopically and radiologically after ESS between 2006 and 2012. The study was designed as a case series with planned data collection in the setting of university medical centers. Patients were followed-up for ≥ 6 months after ESS (mean, 13.1 months). Both pre- and post-operative computed tomography (CT) findings of each sinus and olfactory cleft (OC) were scored according to the Lund-Mackay scoring system: 0, normal; 1, partially; or 2, completely occupied. CT score represents the total score expressed as a percentage of the maximum possible score (12 points per side). Post-operative endoscopic score (E score, %) was calculated as the maximum score according to physical findings on each operated sinus and OC: 0, normal; 1, partially diseased; or 2, completely closed. Post-operative course using E score was verified by comparison with the Lund-Kennedy (L-K) scoring system.
  
  
  RESULTS
  E score was easily and quickly determined. Interclass correlation coefficient among 10 otolaryngologists indicated high-level inter-rater reliability (0.922). E score correlated strongly with both CT score (n=116, p<0.0001, rs=0.755) and L-K score (n=79, p<0.0001, rs=0.723).
  
  
  CONCLUSIONS
  Endoscopic evaluation using E score for sinuses and OCs after ESS is a useful method, together with L-K score for the nasal cavity and radiological study.
authors.affiliation: Department of Otolaryngology, Hyogo College of Medicine, Japan. Electronic address: kenzo@hyo-med.ac.jp.
authors.forename: Kenzo
authors.initials: K
authors.lastname: Tsuzuki
authors.affiliation: Department of Otorhinolaryngology, Showa University School of Medicine, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Hinohira
authors.affiliation: Department of Otolaryngology, Hyogo College of Medicine, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Takebayashi
authors.affiliation: Department of Otolaryngology, Hyogo College of Medicine, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kojima
authors.affiliation: Department of Otolaryngology, Hyogo College of Medicine, Japan.
authors.forename: Yoriko
authors.initials: Y
authors.lastname: Yukitatsu
authors.affiliation: Department of Biostatistics, Hyogo College of Medicine, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Daimon
authors.affiliation: Department of Otolaryngology, Hyogo College of Medicine, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Sakagami
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012220:Rhinitis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D012852:Sinusitis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
keywords: CT score; Chronic rhinosinusitis; Endoscopic sinus surgery; Post-operative endoscopic score; Post-operative evaluation