The Impact of Endoscopic Sinus Surgery on Long-Term Medication Usage in Chronic Rhinosinusitis
Authors List
Yin, T., The University of Auckland, Auckland, New Zealand
Biswas, K., The University of Auckland, Auckland, New Zealand
Douglas, R., The University of Auckland, Auckland, New Zealand
Introduction: Endoscopic sinus surgery is recommended for chronic rhinosinusitis refractory to medical therapy. There is evidence that surgery not only leads to improved symptoms but also reduces the need for ongoing antibiotics and steroids in the medium term. We aim to determine the effect of surgery on long-term medication usage.
Aims: To compare oral antibiotic and steroid use in chronic rhinosinusitis patients 12 months before and after endoscopic sinus surgery. We also compare pre-op and post-op Sino-nasal Outcome Test (SNOT-22) scores.
Methods: We reviewed electronic pharmacy dispensing data from chronic rhinosinusitis patients who underwent endoscopic sinus surgery between May 2014 and April 2019. Oral antibiotic and steroid prescriptions were recorded 12 months pre-op, 0-3 months post-op and 3-15 months post-op. Medications taken 0-3 months post-op included those prescribed on discharge from surgery and during post-operative healing. Patient demographics, disease status and SNOT-22 scores were also obtained. Additional long-term follow up SNOT-22 scores were requested from patients.
Results: 74 chronic rhinosinusitis patients with complete medication data, including 25 patients with long-term SNOT-22 follow up scores, were included for analysis. Endoscopic sinus surgery reduced oral steroid courses 3-15 months post-op (p = 0.005) and follow up SNOT-22 scores (p < 0.01) but did not result in a statistically significant reduction in oral antibiotic courses post-op (p = 0.07).
Conclusions: Chronic rhinosinusitis patients require long-term medical treatment which is only partially reduced with endoscopic sinus surgery. While surgery improves long-term symptom scores, it does not eliminate the need for ongoing oral antibiotic and steroid therapy.
Yin, T., The University of Auckland, Auckland, New Zealand
Biswas, K., The University of Auckland, Auckland, New Zealand
Douglas, R., The University of Auckland, Auckland, New Zealand
Introduction: Endoscopic sinus surgery is recommended for chronic rhinosinusitis refractory to medical therapy. There is evidence that surgery not only leads to improved symptoms but also reduces the need for ongoing antibiotics and steroids in the medium term. We aim to determine the effect of surgery on long-term medication usage.
Aims: To compare oral antibiotic and steroid use in chronic rhinosinusitis patients 12 months before and after endoscopic sinus surgery. We also compare pre-op and post-op Sino-nasal Outcome Test (SNOT-22) scores.
Methods: We reviewed electronic pharmacy dispensing data from chronic rhinosinusitis patients who underwent endoscopic sinus surgery between May 2014 and April 2019. Oral antibiotic and steroid prescriptions were recorded 12 months pre-op, 0-3 months post-op and 3-15 months post-op. Medications taken 0-3 months post-op included those prescribed on discharge from surgery and during post-operative healing. Patient demographics, disease status and SNOT-22 scores were also obtained. Additional long-term follow up SNOT-22 scores were requested from patients.
Results: 74 chronic rhinosinusitis patients with complete medication data, including 25 patients with long-term SNOT-22 follow up scores, were included for analysis. Endoscopic sinus surgery reduced oral steroid courses 3-15 months post-op (p = 0.005) and follow up SNOT-22 scores (p < 0.01) but did not result in a statistically significant reduction in oral antibiotic courses post-op (p = 0.07).
Conclusions: Chronic rhinosinusitis patients require long-term medical treatment which is only partially reduced with endoscopic sinus surgery. While surgery improves long-term symptom scores, it does not eliminate the need for ongoing oral antibiotic and steroid therapy.
