Modified Lund Mackay Postoperative Endoscopy Score for defining inflammatory burden in chronic rhinosinusitis

Area of Science:

• Otolaryngology
• Rhinology
• Surgical Outcomes

Background:

• The Lund Mackay Postoperative Endoscopy Score (LMES) has limitations in assessing patient experience in chronic rhinosinusitis (CRS).
• A need exists for objective measures that better reflect the inflammatory burden post-endoscopic sinus surgery (ESS).

Purpose of the Study:

• To introduce and validate a Modified Lund Mackay Postoperative Endoscopy Score (MLMES) for CRS.
• To evaluate the correlation between the MLMES and patient-reported outcome measures (PROMs).
• To assess the reliability of the MLMES in a postoperative setting.

Main Methods:

• A prospective study involving 30 CRS patients undergoing ESS.
• Endoscopic evaluation at 6 and 12 weeks post-surgery using the MLMES, recording mucosal changes, mucus, and purulence.
• Correlation analysis with visual analogue scale, global anchor score, Sino-Nasal Outcome Test 22 (SNOT-22), and nasal symptom score.
• Assessment of inter-observer and intra-observer reliability.

Main Results:

• The MLMES demonstrated significant correlations with visual analogue scale, SNOT-22, global anchor score, and nasal symptom score.
• Changes in MLMES correlated well with changes in SNOT-22 and nasal symptom score.
• Excellent inter-observer and intra-observer reliability were achieved for the MLMES.

Conclusions:

• The MLMES provides an objective measurement of total sinus inflammatory burden in post-ESS patients.
• The MLMES shows strong correlation with PROMs, suggesting it is a valuable tool for assessing CRS outcomes.
• The MLMES is a reliable and improved objective measure for evaluating postoperative CRS management.