What is the optimal outcome after endoscopic sinus surgery in the treatment of chronic rhinosinusitis? A consultation of Canadian experts
Abstract Objectives Many experts feel that in the absence of well-defined goals for success, they have an easier time identifying failure. As success ought to not be defined only by absence of failure, we aimed to define optimal outcomes for endoscopic sinus surgery (ESS) in chronic rhinosinusitis (...
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SAGE Publishing
2021-06-01
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| Series: | Journal of Otolaryngology - Head and Neck Surgery |
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| Online Access: | https://doi.org/10.1186/s40463-021-00519-9 |
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| author | Nadim Saydy Sami P. Moubayed Marie Bussières Arif Janjua Shaun Kilty François Lavigne Eric Monteiro Smriti Nayan Marilou Piché Kristine Smith Doron Sommer Leigh Sowerby Marc A. Tewfik Ian J. Witterick Erin Wright Martin Desrosiers |
| author_facet | Nadim Saydy Sami P. Moubayed Marie Bussières Arif Janjua Shaun Kilty François Lavigne Eric Monteiro Smriti Nayan Marilou Piché Kristine Smith Doron Sommer Leigh Sowerby Marc A. Tewfik Ian J. Witterick Erin Wright Martin Desrosiers |
| author_sort | Nadim Saydy |
| collection | DOAJ |
| description | Abstract Objectives Many experts feel that in the absence of well-defined goals for success, they have an easier time identifying failure. As success ought to not be defined only by absence of failure, we aimed to define optimal outcomes for endoscopic sinus surgery (ESS) in chronic rhinosinusitis (CRS) by obtaining expert surgeon perspectives. Methods A total of 12 surgeons participated in this targeted consultation. Face to face semi-structured interviews were performed with expert surgeons in the field of CRS and ESS. General impressions and personal definitions of acceptable operative success and optimal operative outcomes were compiled and summarized. Results According to an expert survey, patients’ main objectives are an improvement in their chief complain, a general improvement in quality of life (QoL), and a better overall symptomatic control. The most important aspects of endoscopy for defining a successful intervention were an adequate mucus circulation, a healthy mucosa, minimal edema, and patency of all explored cavities or ostia. In the assessment of surgical outcomes, it was determined that both objective and patient reported data must be carefully examined, with more attention given to subjective outcomes. Conclusions According to data gathered from a Canadian expert consultation, a definition of success must be based on both subjective data and nasal endoscopy. We propose to define an acceptable outcome as either a subjective improvement of at least the minimal clinically improvement difference of a validated patient reported outcome questionnaire, along with a satisfactory endoscopic result (1) or a complete subjective resolution with a sub-optimal endoscopy (2). Graphical abstract |
| format | Article |
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| institution | Kabale University |
| issn | 1916-0216 |
| language | English |
| publishDate | 2021-06-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Otolaryngology - Head and Neck Surgery |
| spelling | doaj-art-c946c7da54b14319a10a85299634f6462025-01-03T01:45:57ZengSAGE PublishingJournal of Otolaryngology - Head and Neck Surgery1916-02162021-06-0150111010.1186/s40463-021-00519-9What is the optimal outcome after endoscopic sinus surgery in the treatment of chronic rhinosinusitis? A consultation of Canadian expertsNadim Saydy0Sami P. Moubayed1Marie Bussières2Arif Janjua3Shaun Kilty4François Lavigne5Eric Monteiro6Smriti Nayan7Marilou Piché8Kristine Smith9Doron Sommer10Leigh Sowerby11Marc A. Tewfik12Ian J. Witterick13Erin Wright14Martin Desrosiers15Division of Otolaryngology – Head & Neck Surgery, Centre Hospitalier de l’Université de Montréal, Université de MontréalDivision of Otolaryngology – Head & Neck Surgery, Maisonneuve-Rosemont Hospital, Université de MontréalDivision of Otolaryngology – Head & Neck Surgery, Centre Hospitalier de l’Université de Sherbrooke – Hôtel-Dieu Hospital, University of SherbrookeDivision of Otolaryngology – Head & Neck Surgery, Vancouver General Hospital, University of British ColumbiaDivision of Otolaryngology – Head & Neck Surgery, The Ottawa Hospital, University of OttawaDivision of Otolaryngology – Head & Neck Surgery, Centre Hospitalier de l’Université de Montréal, Université de MontréalDivision of Otolaryngology – Head & Neck Surgery, Mount Sinai Hospital, University of TorontoDivision of Otolaryngology – Head & Neck Surgery, Cambridge Memorial Hospital, McMaster UniversityDivision of Otolaryngology – Head & Neck Surgery, Hôpital Saint-Sacrement, Laval UniversityDivision of Otolaryngology – Head & Neck Surgery, Winnipeg Health Sciences Center, University of ManitobaDivision of Otolaryngology – Head & Neck Surgery, Cambridge Memorial Hospital, McMaster UniversityDivision of Otolaryngology – Head & Neck Surgery, St-Joseph’s Hospital, Western UniversityDivision of Otolaryngology – Head & Neck Surgery, Jewish General Hospital, McGill UniversityDivision of Otolaryngology – Head & Neck Surgery, Mount Sinai Hospital, University of TorontoDivision of Otolaryngology – Head & Neck Surgery, Walter C MacKenzie Health Sciences Center, University of AlbertaDivision of Otolaryngology – Head & Neck Surgery, Centre Hospitalier de l’Université de Montréal, Université de MontréalAbstract Objectives Many experts feel that in the absence of well-defined goals for success, they have an easier time identifying failure. As success ought to not be defined only by absence of failure, we aimed to define optimal outcomes for endoscopic sinus surgery (ESS) in chronic rhinosinusitis (CRS) by obtaining expert surgeon perspectives. Methods A total of 12 surgeons participated in this targeted consultation. Face to face semi-structured interviews were performed with expert surgeons in the field of CRS and ESS. General impressions and personal definitions of acceptable operative success and optimal operative outcomes were compiled and summarized. Results According to an expert survey, patients’ main objectives are an improvement in their chief complain, a general improvement in quality of life (QoL), and a better overall symptomatic control. The most important aspects of endoscopy for defining a successful intervention were an adequate mucus circulation, a healthy mucosa, minimal edema, and patency of all explored cavities or ostia. In the assessment of surgical outcomes, it was determined that both objective and patient reported data must be carefully examined, with more attention given to subjective outcomes. Conclusions According to data gathered from a Canadian expert consultation, a definition of success must be based on both subjective data and nasal endoscopy. We propose to define an acceptable outcome as either a subjective improvement of at least the minimal clinically improvement difference of a validated patient reported outcome questionnaire, along with a satisfactory endoscopic result (1) or a complete subjective resolution with a sub-optimal endoscopy (2). Graphical abstracthttps://doi.org/10.1186/s40463-021-00519-9Chronic rhinosinusitisEndoscopic sinus surgeryPatient-centered careShort title: Impressions of endoscopic sinus surgery. |
| spellingShingle | Nadim Saydy Sami P. Moubayed Marie Bussières Arif Janjua Shaun Kilty François Lavigne Eric Monteiro Smriti Nayan Marilou Piché Kristine Smith Doron Sommer Leigh Sowerby Marc A. Tewfik Ian J. Witterick Erin Wright Martin Desrosiers What is the optimal outcome after endoscopic sinus surgery in the treatment of chronic rhinosinusitis? A consultation of Canadian experts Journal of Otolaryngology - Head and Neck Surgery Chronic rhinosinusitis Endoscopic sinus surgery Patient-centered care Short title: Impressions of endoscopic sinus surgery. |
| title | What is the optimal outcome after endoscopic sinus surgery in the treatment of chronic rhinosinusitis? A consultation of Canadian experts |
| title_full | What is the optimal outcome after endoscopic sinus surgery in the treatment of chronic rhinosinusitis? A consultation of Canadian experts |
| title_fullStr | What is the optimal outcome after endoscopic sinus surgery in the treatment of chronic rhinosinusitis? A consultation of Canadian experts |
| title_full_unstemmed | What is the optimal outcome after endoscopic sinus surgery in the treatment of chronic rhinosinusitis? A consultation of Canadian experts |
| title_short | What is the optimal outcome after endoscopic sinus surgery in the treatment of chronic rhinosinusitis? A consultation of Canadian experts |
| title_sort | what is the optimal outcome after endoscopic sinus surgery in the treatment of chronic rhinosinusitis a consultation of canadian experts |
| topic | Chronic rhinosinusitis Endoscopic sinus surgery Patient-centered care Short title: Impressions of endoscopic sinus surgery. |
| url | https://doi.org/10.1186/s40463-021-00519-9 |
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