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Outcomes and cost benefits of functional endoscopic sinus surgery in severely asthmatic patients with chronic rhinosinusitis

Published online by Cambridge University Press:  30 May 2014

Y Al Badaai ,
C J Valdés  and
M Samaha
Y Al Badaai
Affiliation:
Division of Otolaryngology – Head and Neck Surgery, Department of Surgery, Sultan Qaboos University Hospital, Muscat, Oman
C J Valdés
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Royal Victoria Hospital, McGill University Health Centre, Montreal, Quebec, Canada
M Samaha*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Royal Victoria Hospital, McGill University Health Centre, Montreal, Quebec, Canada
*
Address for correspondence: Dr M Samaha, 687 Pine Ave, E-45, Montreal, Quebec H3A 1A1, Canada Fax: 001 514 731 5760 E-mail: [email protected]
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Abstract

Objectives:

To evaluate the outcomes (using validated outcome tools) and cost benefits of functional endoscopic sinus surgery in a population of severely asthmatic patients with chronic rhinosinusitis.

Methods:

A prospective cohort study was conducted. The study comprised consecutive patients diagnosed with asthma and chronic rhinosinusitis for whom medical treatment had failed and who were scheduled for functional endoscopic sinus surgery. General health and disease-specific outcome questionnaires were completed pre- and post-operatively. Costs associated with both functional endoscopic sinus surgery and out-patient visits to a comprehensive asthma clinic were calculated.

Results:

A total of 47 patients completed the surveys. The average improvement in Chronic Sinusitis Survey scores following functional endoscopic sinus surgery was 17 per cent. The average reduction in out-patient asthma clinic visits was 50 per cent, which translates to an average cost saving of $1035 Canadian dollars per patient per year.

Conclusion:

Functional endoscopic sinus surgery is a cost-effective treatment modality for asthmatic patients with chronic rhinosinusitis. This information is important for: the distribution and planning of resources, prioritising health programmes, and establishing practice guidelines.

Keywords

SinusitisAsthmaNatural Orifice Endoscopic SurgeryCost Benefit
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 6 , June 2014 , pp. 512 - 517
Copyright
Copyright © JLO (1984) Limited 2014 

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References

1Lethbridge-Cejku, M, Schiller, JS, Bernadel, L. Summary health statistics for U.S. adults: National Health Interview Survey, 2002. Vital Health Stat 10 2004;222:1–151Google Scholar
2Durr, DG, Desrosiers, MY, Dassa, C. Impact of rhinosinusitis in health care delivery: the Quebec experience. J Otolaryngol 2001;30:93–7Google Scholar
3Benninger, MS, Ferguson, BJ, Hadley, JA, Hamilos, DL, Jacobs, M, Kennedy, DW et al. Adult chronic rhinosinusitis: definitions, diagnosis, epidemiology, and pathophysiology. Otolaryngol Head Neck Surg 2003;129:S1–32Google Scholar
4Senior, BA, Kennedy, DW, Tanabodee, J, Kroger, H, Hassab, M, Lanza, DC. Long-term impact of functional endoscopic sinus surgery on asthma. Otolaryngol Head Neck Surg 1999;121:66–8CrossRefGoogle ScholarPubMed
5Krouse, JH. The unified airway–conceptual framework. Otolaryngol Clin North Am 2008;41:257–66CrossRefGoogle ScholarPubMed
6Gaga, M, Lambrou, P, Papageorgiou, N, Koulouris, NG, Kosmas, E, Fragakis, S et al. Eosinophils are a feature of upper and lower airway pathology in non-atopic asthma, irrespective of the presence of rhinitis. Clin Exp Allergy 2000;30:663–9CrossRefGoogle ScholarPubMed
7Braunstahl, GJ, Kleinjan, A, Overbeek, SE, Prins, JB, Hoogsteden, HC, Fokkens, WJ. Segmental bronchial provocation induces nasal inflammation in allergic rhinitis patients. Am J Respir Crit Care Med 2000;161:2051–7Google Scholar
8Passalacqua, G, Ciprandi, G, Canonica, GW. United airways disease: therapeutic aspects. Thorax 2000;55:S26–7Google Scholar
9Batra, PS, Kern, RC, Tripathi, A, Conley, DB, Ditto, AM, Haines, GK 3rd et al. Outcome analysis of endoscopic sinus surgery in patients with nasal polyps and asthma. Laryngoscope 2003;113:1703–6Google Scholar
10Ikeda, K, Tanno, N, Tamura, G, Suzuki, H, Oshima, T, Shimomura, A et al. Endoscopic sinus surgery improves pulmonary function in patients with asthma associated with chronic sinusitis. Ann Otol Rhinol Laryngol 1999;108:355–9Google Scholar
11Ragab, S, Scadding, GK, Lund, VJ, Saleh, H. Treatment of chronic rhinosinusitis and its effects on asthma. Eur Respir J 2006;28:68–74Google Scholar
12Bresciani, M, Paradis, L, Des Roches, A, Vernhet, H, Vachier, I, Godard, P et al. Rhinosinusitis in severe asthma. J Allergy Clin Immunol 2001;107:73–80CrossRefGoogle ScholarPubMed
13Pearlman, AN, Chandra, RK, Chang, D, Conley, DB, Tripathi-Peters, A, Grammer, LC et al. Relationships between severity of chronic rhinosinusitis and nasal polyposis, asthma, and atopy. Am J Rhinol Allergy 2009;23:145–8CrossRefGoogle ScholarPubMed
14Ware, JE Jr, Kosinski, M, Turner-Bowker, DM, Gandek, B. How to Score Version 2 of the SF-12® Health Survey (With a Supplement Documenting Version 1). Lincoln, Rhode Island: QualityMetric, 2002Google Scholar
15Gliklich, RE, Metson, R. Effect of sinus surgery on quality of life. Otolaryngol Head Neck Surg 1997;117:12–17CrossRefGoogle ScholarPubMed
16Gliklich, RE, Metson, R. Techniques for outcomes research in chronic sinusitis. Laryngoscope 1995;105:387–90CrossRefGoogle ScholarPubMed
17Metson, R, Gliklich, RE. Computed tomography to evaluate chronic sinusitis. JAMA 1994;272:852CrossRefGoogle ScholarPubMed
18Fasano, MB. Combined airways: impact of upper airway on lower airway. Curr Opin Otolaryngol Head Neck Surg 2010;18:15–20CrossRefGoogle ScholarPubMed
19Baroody, FM, Hughes, CA, McDowell, P, Hruban, R, Zinreich, SJ, Naclerio, RM. Eosinophilia in chronic childhood sinusitis. Arch Otolaryngol Head Neck Surg 1995;121:1396–402Google Scholar
20Awad, OG, Fasano, MB, Lee, JH, Graham, SM. Asthma outcomes after endoscopic sinus surgery in aspirin-tolerant versus aspirin-induced asthmatic patients. Am J Rhinol 2008;22:197–203Google Scholar
21Dunlop, G, Scadding, GK, Lund, VJ. The effect of endoscopic sinus surgery on asthma: management of patients with chronic rhinosinusitis, nasal polyposis, and asthma. Am J Rhinol 1999;13:261–5Google Scholar
22Ehnhage, A, Olsson, P, Kolbeck, KG, Skedinger, M, Dahlen, B, Alenius, M et al. Functional endoscopic sinus surgery improved asthma symptoms as well as PEFR and olfaction in patients with nasal polyposis. Allergy 2009;64:762–9CrossRefGoogle ScholarPubMed
23Nishioka, GJ, Cook, PR, Davis, WE, McKinsey, JP. Functional endoscopic sinus surgery in patients with chronic sinusitis and asthma. Otolaryngol Head Neck Surg 1994;110:494–500Google Scholar
24Uri, N, Cohen-Kerem, R, Barzilai, G, Greenberg, E, Doweck, I, Weiler-Ravell, D. Functional endoscopic sinus surgery in the treatment of massive polyposis in asthmatic patients. J Laryngol Otol 2002;116:185–9Google Scholar
25Laurier, C, Kennedy, W, Malo, JL, Par, M, Labb, D, Archambault, A. Rate and cost of hospitalizations for asthma in Quebec: an analysis of 1988/89, 1989/90 and 1994/95 data. Chronic Dis Can 1999;20:82–8Google ScholarPubMed
26Gliklich, RE, Hilinski, JM. Longitudinal sensitivity of generic and specific health measures in chronic sinusitis. Qual Life Res 1995;4:27–32Google Scholar
27Bessette, L, Sangha, O, Kuntz, KM, Keller, RB, Lew, RA, Fossel, AH et al. Comparative responsiveness of generic versus disease-specific and weighted versus unweighted health status measures in carpal tunnel syndrome. Med Care 1998;36:491–502CrossRefGoogle ScholarPubMed
28Gandek, B, Ware, JE, Aaronson, NK, Apolone, G, Bjorner, JB, Brazier, JE et al. Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project. International Quality of Life Assessment. J Clin Epidemiol 1998;51:1171–8CrossRefGoogle ScholarPubMed