Establishing a threshold for surgery in recurrent acute rhinosinusitis

May 10, 2012

A study in the May 2012 issue of Otolaryngology–Head and Neck Surgery suggests a threshold for when to choose surgery over medical therapy for recurrent acute rhinosinusitis (RARS) based on the patients' lost productivity in response to RARS and each treatment strategy.

The authors compare the burden of and the burden of disease. On one hand, "Surgery and postoperative convalescence for comprehensive endoscopic sinus surgery can take 5 to 7 days or 3 to 5 workdays…," they write. However, the impact of each bout of infection also diminishes quality of life through absenteeism and partial productivity.

In this study, the authors find that the productivity lost to surgery is outweighed by the productivity lost to illness when patients suffer 4 or more episodes of RARS a year. To counteract the fact that patients may have difficulty distinguishing between an episode of RARS and the 2 viral upper respiratory infections suffered by the average North American each year, the authors suggest using a threshold of 6 episodes per year.

The authors caution, "…productivity is not a perfect surrogate for quality of life… and is not the only way people are affected by a disease. …variability in the degree of debilitation with each infection requires discussion between the clinician and patient to fully appreciate the impact of the disease on an individual basis…" Nonetheless, this threshold provides the first step to a meaningful discussion in patient-centered decision making.

Explore further: Review of multilevel surgery in patients with obstructive sleep apnea

Related Stories

Recommended for you

3-D-printable implants may ease damaged knees

April 19, 2017

A cartilage-mimicking material created by researchers at Duke University may one day allow surgeons to 3-D print replacement knee parts that are custom-shaped to each patient's anatomy.

Stem cell innovation regrows rotator cuffs

April 3, 2017

Every time you throw a ball, swing a golf club, reach for a jar on a shelf, or cradle a baby, you can thank your rotator cuff. This nest of tendons connecting your arm bone to your shoulder socket is a functional marvel, ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.