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Dr. Sadaf Qadeer is an ENT specialist with special interest in Rhinology . She is apt in Endoscopic surgery with emphasis on immunology and allergy. This study is first of its kind in Pakistani population. This study sheds light on the main subtypes of chronic rhinosinusitiis and post-operative quality of life after FESS in such patients.
Introduction: Chronic Rhinosinusitis (CRS) is a group of disorders characterized by the inflammation of mucosa of the nasal passages and paranasal sinuses.It includes chronic rhinosinusitis with polyps, CRS without polyps and Allergic Fungal Sinusitis(AFS). This debilitating disease causes negative impact on quality of life (QOL) of patients.Functional endoscopic sinus surgery(FESS) is the mainstay of surgical treatment for patients and improves QOL of patients.This subjective assessement of QOL can be measured by disease specific questionnaires. SNOT-22 questionnaire is widely used and validated questionnaire for this purpose.Objective: To compare the quality of life after functional endoscopic sinus surgery in patients with subtypes of chronic rhinosinusitis. Material and Methods: Prospective study was done on 54 patients. Data was collected using SNOT-22 questionnaire and filled in pre-operative period then in post-operative follow-up visits on 1st,3rd,6th and 12th months. Paired sample t-test was used to compare pre-operative and post-operative SNOT scores and multivariate generalized linear model was used to estimate regression parameters for SNOT scores in CRS with polyp and AFS in comparison of CRS without polyps. Results: Out of 54 patients,59.3% were males,mean age was 35.98,29.6% were in CRS without polyp group,44.4% and 25.9% were in CRS with polyps and AFS group. Recurrence occurred in 7.4%,revision surgery required in 3.7% while 22.2% had history of asthma. Paired sampe t-test showed statistical significant reduction in post-operative SNOT scores. Linear model results showed SNOT scores in CRS with polyp group was significantly reduced. Conclusion: FESS provides significant improvement in QOL of patients in chronic rhinosinusitis. Publications: 1. Ehnhage et al. One year after endoscopic sinus surgery in polyposis: Asthma, olfaction and quality of life outcomes. Otolaryngol head and neck surg. Dec 2011. 2. Bezerra T et al. Assessment of quality of life after endoscopic sinus surgery for chronic rhinosinusitis. Braz J Otorhinolaryngol. 2012;78(2):96-102 3. Marambaia PP, Lima MG, Santos KP, et al. Evaluation of quality of life of patients with chronic rhinosinusitis by means of the SNOT-22 questionnaire.Braz JOtorhinolaryngol.2013;79(1):54-8. 4. Hopkins C, Gillett S et al. Psychometric validity of the 22-item sinonasal outcome test.Clinical Otolaryngology.2009:34:447-454. 5. Mascarenhas JG, Fonseca VMG, Chen VG, et al.Long term outcomes of endoscopic sinus surgery for chronic rhinosinusitis with and without polyps. Braz J Otorhinolaryngol.2013;79(3):306-11.