A total of 235 patients with chronic rhinosinusitis were enrolled in the study; 50 were smokers and 185 were nonsmokers. Preoperative SNOT-20 differences for smokers and nonsmokers were not statistically significant. At short-term follow-up after surgery, both groups had a significant reduction in SNOT-20 scores, but surprisingly, smokers had a statistically significant greater reduction than nonsmokers.
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December 2007The investigators surmise that the significant improvement in quality of life that appears in early follow-up deteriorates over time and would not be present at longer-term follow-up; they plan to perform further analyses of this cohort to see if this will be the case.
The researchers point out that the results of this study call into question the idea that smokers are poor candidates for functional endoscopic sinus surgery (FESS), at least in the short term. The pathophysiology of smoke-induced chronic rhinosinusitis may be more amenable to FESS. Ongoing smoking, however, may lead to further damage and scarring, requiring more revision surgery in the long term.
(Laryngoscope 2007;117:2229-32)
References
- Setzen M, Cohen MA, Perlman PW, et al. The association between laryngopharyngeal sensory deficits, pharyngeal motor function, and the prevalence of aspiration with thin liquids. Otolaryngol Head Neck Surg 2003;128(1):99–102.
- Rees CJ. Flexible endoscopic evaluation of swallowing with sensory testing. Curr Opin Otolaryngol Head Neck Surg 2006;14(6):425–30.
- Link DT, Willging JP, Miller CK, et al. Pediatric laryngopharyngeal sensory testing during flexible endoscopic evaluation of swallowing. Ann Otol Rhinol Laryngol 2000;109(10 Pt. 1): 99–905.
- Aviv JE. Prospective, randomized outcome study of endoscopy versus modified barium swallow in patients with dysphagia. Laryngoscope 2000 Apr; 110(4): 563–74.
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