On health-related quality of life in chronic rhinosinusitis and endoscopic endonasal surgery
On health-related quality of life in chronic rhinosinusitis and endoscopic endonasal surgery
Chronic rhinosinusitis (CRS) is an inflammation of the mucosa of the nose and paranasal sinuses. Inverted papilloma (IP) is a rare, benign tumor of the sinonasal cavities. Both conditions can have a significant negative impact on health-related quality of life (HRQoL). The Endoscopic Endonasal Sinus and Skull Base Surgery Questionnaire (EES-Q) was developed to assess HRQoL after endoscopic endonasal surgery (EES) and was initially validated only in surgically treated patients.
Part 1 of this thesis of Marc den Heijer investigated the applicability of the EES-Q in patients with CRS. The questionnaire proved to be reliable and suitable for use regardless of treatment phase. In addition, the concept of clinical control was evaluated; the commonly used EPOS classification showed limitations, whereas the EES-Q provided a more nuanced perspective.
Part 2 explored postoperative HRQoL following EES in patients with IP and CRSwNP. In IP patients, HRQoL returned to baseline within three to twelve months. Worse preoperative HRQoL, a higher ASA score, and postoperative use of antibiotics were associated with greater improvement. Similar improvements were observed in CRSwNP patients, where poorer preoperative HRQoL also predicted more substantial postoperative gains. Eosinophilia was found to be associated with an increased risk of revision surgery.
This thesis highlights the value of the EES-Q in measuring HRQoL and aims to enhance patient-centred healthcare.