title: Using postoperative SNOT-22 to help predict the probability of revision sinus surgery.
abstract: There is a need to develop a patient-level strategy to identify those at higher risk of requiring revision ESS since this may assist clinicians in tailoring their postoperative management. This study evaluated whether identifying changes in the post- operative 22-item Sinonasal Outcome Test (SNOT-22) can help identify patients at increased risk of needing revision sinus surgery for refractory chronic rhinosinusitis (CRS).
  
  
  
  668 CRS patients undergoing primary ESS with complete 60-month follow-up were evaluated in this prospective, longitudinal cohort study. Outcomes were evaluated in an unselected cohort and a low-risk cohort, which was comprised of patients without a history of asthma or aspirin sensitivity.
  
  
  
  Failing to achieve an improvement of greater than one minimal clinically important difference (MCID; 9 points) at 3 months after primary ESS and a deterioration of greater than one MCID (ie. >9 points) from the 3- to 12-month follow-up periods was associated with an increased risk of revision ESS in both the unselected and low-risk CRS cohorts.
  
  
  
  Outcomes from this study suggest that identifying MCID changes in the SNOT-22 score within 12 months after primary ESS can identify patients at increased risk for needing revision surgery.
authors.affiliation: Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, AB, Canada.
authors.forename: Luke
authors.initials: L
authors.lastname: Rudmik
authors.affiliation: Division of Rhinology and Sinus Surgery, Department of Otolaryngology, Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Zachary M
authors.initials: ZM
authors.lastname: Soler
authors.affiliation: Department of ENT, Guy s and St Thomas NHS Trust, London, United Kingdom.
authors.forename: Claire
authors.initials: C
authors.lastname: Hopkins
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures; D010256:Paranasal Sinuses / Q000601:surgery*; D011336:Probability; D011446:Prospective Studies; D012086:Reoperation; D012220:Rhinitis / Q000601:surgery*; D012852:Sinusitis / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome