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80th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

20.05. - 24.05.2009, Rostock

Outcome and process quality in endoscopic sinus surgery in Greifswald

Meeting Abstract

  • author Dana Bussler - Dept. of Otorhinolaryngology, Head & Neck Surgery,University of Greifswald, Greifswald, Germany
  • author Elke Steinmeier - Dept. of Otorhinolaryngology, Head & Neck Surgery,University of Greifswald, Greifswald, Germany
  • author Thomas Kohlmann - Division of Methods in Community Medicine, University of Greifswald, Greifswald, Germany
  • author Werner Hosemann - Dept. of Otorhinolaryngology, Head & Neck Surgery,University of Greifswald, Greifswald, Germany
  • corresponding author Achim Beule - Dept. of Otorhinolaryngology, Head & Neck Surgery,University of Greifswald, Greifswald, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 80th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Rostock, 20.-24.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. Doc09hno084

DOI: 10.3205/09hno084, URN: urn:nbn:de:0183-09hno0844

Published: July 22, 2009

© 2009 Bussler et al.
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Outline

Text

Introduction: As long as conservative therapy doesn’t lead to a satisfactory relief in symptoms, endoscopic sinus surgery is the standard therapy in patients with chronic sinusitis. In order to analyze the course and costs of surgical treatment, data from Germany are missing.

Methods: Patients have been examined standardized prospective pre-operative and 6 months after surgical treatment by means of endoscopy, CT scan of paranasal sinuses (only before surgery) and questionnaires concerning general and specific life quality (SNOT 20D, SF 36, Lund Score). Diaries of patients were used in order to analyze the economic influence of the disease regarding drug use (prescription of drugs), duration of hospitalization and sick leave as well as the frequency of consulting a doctor (general practitioner as well as ENT specialist).

Results: A total of 163 patients were recruited with complete examination available in 101 patients preoperatively and in 94 patients postoperatively. 61 patients filled in a diary during their first postoperative month. In 48 patients, pre- and postoperative questionnaires were available for direct measurement of treatment effects. With regard to the disease symptoms the sum of the points in the SNOT questionnaire was stated by patients with 25 on average. After 6 months recurrence of polyps was observed in 3.8% on the left side and 10.1% on the right side respectively. Postoperative adhesions were notable on the left side in 6 patients (7.6%; 4 minor, 2 moderate) and in 11 patients on the right side(13.9%; 8 minor, 2 moderate, 1 severe). On average, patients were unable to work for 17.4±12.4 days, among them smoking and younger patients (<48 years) longer than older and non-smoking patients. A topical steroid was used for 100 days on average. After surgical treatment, patients have been examined by an ENT physician for 7.8 times on average, mainly in the second week after discharge. Measuring the common and specific quality of life an improvement could be detected.

Conclusions: The examined cohort showed an improved common and specific quality of life after endoscopic sinus surgery. With regard to the economic influence a remarkable use of drugs and a remarkable duration of sick leave was noticed. Besides, indirect costs due to postoperative care seem to be considerable in Germany.