Quality of life and impact of surgery on patients with chronic rhinosinusitis

Objective: To measure the impact of chronic rhinosinusitis (CRS) on the health of Nova Scotians and evaluate the role of surgery in modifying this impact. Methods: Nova Scotia residents with CRS referred to one otolaryngologist were enrolled. The Chronic Sinusitis Survey (CSS) and Short Form 36-Item Health Survey (SF-36) were administered preoperatively and at two postoperative visits. The SF-36 data were compared with Canadian published norms. Also, the postoperative survey results were compared with preoperative data to evaluate the role of surgery in improving health. Results: Thirty-eight patients completed preoperative and 3-month forms, and 26 patients completed preoperative and 3- and 12-month postoperative forms. Patients with CRS showed a significant decrease in five of eight SF-36 subscales. Surgery significantly improved preoperative scores for six of eight subscales and both the physical (PCS) and mental (MCS) component summary scores (p < .05). Males were more likely than females to report postoperative improvements (p = .02). Males under 50 years were more likely to show improvement in the PCS score (p = .02), with no significant change in the MCS score. Females under 50 years were more likely to show improvement in the MCS score (p = .02), with age having no effect on PCS score. Conclusion: This study confirms that Canadians with CRS have lower quality of life and for the first time in Canada demonstrates that functional endoscopic sinus surgery can restore health. Males showed a greater response than females, and patients under 50 years were more likely to improve after surgery. This information on patient factors influencing outcomes may help physicians when counseling patients regarding surgery for CRS.