What is the optimal outcome after endoscopic sinus surgery in the treatment of chronic rhinosinusitis? A consultation of Canadian experts

Journal of Otolaryngology - Head and Neck Surgery

Smriti Nayan¹  Doron Sommer¹  Nadim Saydy²  François Lavigne²  Martin Desrosiers²  Marie Bussières³  Marilou Piché⁴  Marc A. Tewfik⁵  Sami P. Moubayed⁶  Eric Monteiro⁷  Ian J. Witterick⁷  Leigh Sowerby⁸  Shaun Kilty⁹  Arif Janjua^1,10  Erin Wright^1,11  Kristine Smith^1,12 

[1] Division of Otolaryngology – Head & Neck Surgery, Cambridge Memorial Hospital, McMaster University;Division of Otolaryngology – Head & Neck Surgery, Centre Hospitalier de l’Université de Montréal, Université de Montréal;Division of Otolaryngology – Head & Neck Surgery, Centre Hospitalier de l’Université de Sherbrooke – Hôtel-Dieu Hospital, University of Sherbrooke;Division of Otolaryngology – Head & Neck Surgery, Hôpital Saint-Sacrement, Laval University;Division of Otolaryngology – Head & Neck Surgery, Jewish General Hospital, McGill University;Division of Otolaryngology – Head & Neck Surgery, Maisonneuve-Rosemont Hospital, Université de Montréal;Division of Otolaryngology – Head & Neck Surgery, Mount Sinai Hospital, University of Toronto;Division of Otolaryngology – Head & Neck Surgery, St-Joseph’s Hospital, Western University;Division of Otolaryngology – Head & Neck Surgery, The Ottawa Hospital, University of Ottawa;Division of Otolaryngology – Head & Neck Surgery, Vancouver General Hospital, University of British Columbia;Division of Otolaryngology – Head & Neck Surgery, Walter C MacKenzie Health Sciences Center, University of Alberta;Division of Otolaryngology – Head & Neck Surgery, Winnipeg Health Sciences Center, University of Manitoba;

关键词: Chronic rhinosinusitis;    Endoscopic sinus surgery;    Patient-centered care;    Short title: Impressions of endoscopic sinus surgery.;   

DOI  :  10.1186/s40463-021-00519-9

来源: DOAJ

【 摘 要 】

Abstract Objectives Many experts feel that in the absence of well-defined goals for success, they have an easier time identifying failure. As success ought to not be defined only by absence of failure, we aimed to define optimal outcomes for endoscopic sinus surgery (ESS) in chronic rhinosinusitis (CRS) by obtaining expert surgeon perspectives. Methods A total of 12 surgeons participated in this targeted consultation. Face to face semi-structured interviews were performed with expert surgeons in the field of CRS and ESS. General impressions and personal definitions of acceptable operative success and optimal operative outcomes were compiled and summarized. Results According to an expert survey, patients’ main objectives are an improvement in their chief complain, a general improvement in quality of life (QoL), and a better overall symptomatic control. The most important aspects of endoscopy for defining a successful intervention were an adequate mucus circulation, a healthy mucosa, minimal edema, and patency of all explored cavities or ostia. In the assessment of surgical outcomes, it was determined that both objective and patient reported data must be carefully examined, with more attention given to subjective outcomes. Conclusions According to data gathered from a Canadian expert consultation, a definition of success must be based on both subjective data and nasal endoscopy. We propose to define an acceptable outcome as either a subjective improvement of at least the minimal clinically improvement difference of a validated patient reported outcome questionnaire, along with a satisfactory endoscopic result (1) or a complete subjective resolution with a sub-optimal endoscopy (2). Graphical abstract

【 授权许可】

Unknown