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Prognostic factors, outcomes and staging in ethmoid sinus surgery.
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1992
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Interventional PulmonologyPotential BiasOtorhinolaryngologySurgeryClinical EpidemiologySkull Base SurgerySkull BaseEndoscopic SurgeryOutcomes ResearchEndoscopic Sinus SurgerySinusitisPatient SafetyOtolaryngologyThoracic SurgeryInflammatory Sinus DiseaseInterventional EndoscopyCraniofacial SurgeryMedicineEthmoid Sinus Surgery
The literature on chronic inflammatory sinus disease surgery is abundant, yet comparing outcomes is hampered by limited knowledge of prognostic factors and inconsistent success criteria. The study aimed to evaluate surgical outcomes in 120 endoscopic sinus surgery patients through detailed prospective and retrospective data collection. Researchers collected over 240 data fields per patient—including symptoms, endoscopic and CT findings, and surgical details—assessed outcomes via symptom questionnaires and endoscopic follow-up over a mean 18‑month period, and statistically analyzed potential prognostic variables. A strong correlation was found between disease extent and surgical outcome, while other factors were largely insignificant, leading to the proposal of a staging system based on disease extent.
Although the literature is replete with papers discussing the results of surgery for chronic inflammatory sinus disease, critical comparison of results is difficult due to limited knowledge of the prognostic factors and the variable criteria reported for success. Detailed prospective and retrospective data collection was therefore undertaken to evaluate the results of surgical intervention in 120 patients who underwent endoscopic sinus surgery. Results were evaluated both by symptom questionnaire and by endoscopic follow-up examination. Over 240 data fields were collected on each patient, including information regarding presenting symptoms, endoscopic and computed tomography (CT) findings and surgical procedures performed. In order to reduce potential bias, the results of the follow-up questionnaires were compared to questionnaires from other patients unable to return for follow-up endoscopy. Mean follow-up time was 18 months. Potential prognostic variables were evaluated statistically. A strong correlation was identified between the extent of disease and the surgical outcome. Other identified potential factors appeared to have little or no significance. Therefore, a staging system for inflammatory sinus disease based on the extent of disease is suggested.