Endoscopic Management of Chronic Frontal Sinusitis: Prospective Quality of Life Analysis.
BACKGROUND
Previous studies of endoscopic frontal sinus surgery have been primarily retrospective and focused on symptom relief only.


OBJECTIVE
To prospectively assess the impact of endoscopic frontal sinus surgery on frontal sinus ostium patency and disease-specific quality of life as measured by the Rhinosinusitis Disability Index (RSDI).


METHODS
A 60-patient cohort with chronic frontal sinusitis (100 diseased frontal sinuses) was prospectively evaluated using the RSDI, computed tomography (CT) imaging, and endoscopic examination. Image-guided endoscopic frontal sinusotomy (Draf 2a) was performed in each case. Patients were assessed with RSDI and endoscopic assessment at least 6 months postoperatively.


RESULTS
At a mean follow-up of 10 months, endoscopic assessment revealed patent frontal recesses in 90 of 100 frontal sinuses (90%), with significant improvement in the total RSDI score (41.98 ± 26.48 preoperatively to 17.15 ± 15.66 postoperatively) as well as each of its physical, emotional, and functional subscales from 16.3 ± 9.03, 12.23 ± 10.55, 13.45 ± 9.59 preoperatively to 5.95 ± 5.71, 5.55 ± 5.66, 5.65 ± 5.72 postoperatively, respectively. Similar improvement was seen in patients with asthma, polyps, and those undergoing revision sinus surgeries.


CONCLUSIONS
With frontal recess mucosal preservation and meticulous postoperative endoscopic surveillance, endoscopic frontal sinusotomy results in high rates of frontal sinus ostium patency with significant improvement in quality of life.
Tanta University, Otolaryngology/Head and Neck Surgery, Tanta, El-Gharbiya, Egypt.
Mohamed H
MH
Askar
Tanta University, Otolaryngology/Head and Neck Surgery, Tanta, El-Gharbiya, Egypt.
Ahmed
A
Gamea
Tanta University, Otolaryngology/Head and Neck Surgery, Tanta, El-Gharbiya, Egypt University of North Carolina at Chapel Hill, Otolaryngology/Head and Neck Surgery, Chapel Hill, NC, USA Mohamedtomoum@yahoo.com.
Mohamed O
MO
Tomoum
Tanta University, Otolaryngology/Head and Neck Surgery, Tanta, El-Gharbiya, Egypt.
Hossam S
HS
Elsherif
University of North Carolina at Chapel Hill, Otolaryngology/Head and Neck Surgery, Chapel Hill, NC, USA.
Charles
C
Ebert
University of North Carolina at Chapel Hill, Otolaryngology/Head and Neck Surgery, Chapel Hill, NC, USA.
Brent A
BA
Senior
D000328:Adult; D000342:Affective Symptoms / Q000503:physiopathology; D002908:Chronic Disease; D004185:Disability Evaluation; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods; D005260:Female; D005626:Frontal Sinus / Q000000981:diagnostic imaging / Q000601:surgery; D015522:Frontal Sinusitis / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000523:psychology; D011446:Prospective Studies; D011788:Quality of Life; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014481:United States
chronic rhinosinusitis; endoscopic frontal sinusotomy; frontal sinus ostium patency; quality of life; rhinosinusitis disability index