Kurzfristige Lebensqualitätsbewertung nach Nasennebenhöhlenoperation bei chronischer Rhinosinusitis

Zusammenfassung

Hintergrund Die chronische Rhinosinusitis (Chronic rhinosinusitis, CRS) hat negative Auswirkungen auf die gesundheitsbezogene Lebensqualität (Health-Related Quality of Life, HRQoL). Die funktionelle endoskopische Nasennebenhöhlenchirurgie (Functional Endoscopic Sinus Surgery, FESS) ist die Behandlung der Wahl für Patienten, die auf eine konservative Therapie nicht ansprechen. Bisher sind die kurzfristigen Auswirkungen einer FESS auf die HRQoL noch ungeklärt.

Ziel der Arbeit Evaluation der kurzfristigen Auswirkungen einer FESS auf die HRQoL bei CRS-Patienten anhand des SNOT-22-Fragebogens.

Methodik Die Ergebnisse der validierten deutschen Version des Sino-Nasal-Outcome-Test-22 (SNOT-22) -Fragebogens von Patienten mit CRS wurden vor (n=89) und 10–14 Tage (n=77), 4 (n=77), 6 Wochen (n=76) und 6 Monate (n=71) nach einer FESS analysiert und mit denen von 1000 Kontrollpersonen verglichen, die mithilfe einer nicht wahrscheinlichen Quotenstichprobe in Übereinstimmung mit der Verteilung des deutschen Mikrozensus ausgewählt wurden.

Ergebnisse Im Vergleich zum präoperativen Mittelwert des SNOT-22-Scores (47,35) verbesserten CRS-Patienten ihre HRQoL 10–14 Tage (31,75; p<0,01), 4 Wochen (25,84; p<0,01), 6 Wochen (24,16; p<0,01) und 6 Monate nach FESS (27,16; p<0,01) signifikant. Prä- und 6 Monate postoperativ waren die 5 wichtigsten SNOT-22-Items Nasenatmungsbehinderung, Riech- und Geschmacksminderung, dickes, schleimiges Nasensekret, Schnäuzen der Nase notwendig und Sekretfluss in den Rachen. Die Riech- und Geschmacksminderung wurde beim 2-, 4- und 6-Wochen-Follow-up am häufigsten als lebensqualitätseinschränkend empfunden.

Schlussfolgerung Diese Follow-up-Studie zeigt erstmalig, dass kurzzeitig nach FESS die Riech- und Geschmacksminderung schwerpunktmäßig konservativ nachbehandelt und kontrolliert werden sollte.

Abstract

Background Chronic rhinosinusitis (CRS) has a negative impact on health-related quality of life (HRQoL). Functional endoscopic sinus surgery (FESS) is the treatment of choice for those not responding to medical treatments. To date, the short-term effects of FESS on HRQoL are still unclear.

Objective Evaluation of the short-term effects of FESS on HRQoL in CRS patients using the SNOT-22 questionnaire.

Methods The results of the validated German version of the Sino-Nasal Outcome Test-22 (SNOT-22) questionnaire were analysed from 89 patients with CRS before surgery and 10–14 days (n = 77), four (n = 77), six weeks (n = 76) and 6 months (n = 71) after FESS, and compared with those of 1,000 healthy controls selected using a non-probability quota sample in accordance to the distribution of the German Microcensus.

Results Compared to the preoperative mean SNOT-22 score (47.35), CRS patients significantly improved in HRQoL 10–14 days (31.75, p < 0.01), 4 weeks (25.84, p < 0.01), 6 weeks (24.16, p < 0.01) and 6 months after FESS (27.16, p < 0.01). Pre- and 6 months postoperatively, the five most important SNOT-22 items were nasal obstruction, smell and taste reduction, thick, mucous nasal secretions, need to blow the nose and postnasal drip. At the 2, 4 and 6-week follow-up, the reduction in smell and taste was most frequently perceived as limiting the HRQoL.

Conclusions This follow-up study shows for the first time that the reduction in smell and taste should be treated and controlled concervatively in the short term after FESS.

Schlüsselwörter

SNOT-22 - Lebensqualität - FESS - chronische Rhinosinusitis - Kurzzeit-Follow-up

Keywords

SNOT-22 - quality of life - FESS - chronic rhinosinusitis - short-term follow-up

Publication History

Received: 14 November 2023

Accepted after revision: 25 March 2024

Article published online:
16 May 2024

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