Follow-Up Adherence Is Associated with Outcomes After Endoscopic Sinus Surgery

Area of Science:

• Otolaryngology
• Surgical Outcomes
• Quality of Life Research

Background:

• Postoperative clinical follow-up after endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS) is crucial for patient assessment and management.
• The optimal frequency and timing of these visits remain debated.
• The impact of patient adherence to follow-up schedules on disease-specific outcomes is not well understood.

Purpose of the Study:

• To assess the association between adherence to postoperative follow-up schedules and quality of life (QOL) outcomes in patients undergoing ESS for CRS.
• To investigate how different levels of adherence influence symptom return and overall patient well-being over 12 months.

Main Methods:

• A retrospective review of 166 patients who underwent ambulatory ESS for CRS between November 2016 and January 2018.
• Patients were categorized based on adherence to a 1-, 3-, and 5-week postoperative visit schedule: non-adherent, moderately-adherent, and fully-adherent.
• Quality of life was assessed using the 22-item sinonasal outcome test (SNOT-22), alongside sociodemographic characteristics and radiographic severity.

Main Results:

• Fully-adherent patients (33.1%) showed worse immediate postoperative QOL (SNOT-22: 31.2 ± 23.1) compared to moderately-adherent patients (63.2%) (27.5 ± 17.6).
• Fully-adherent patients also exhibited greater psychological dysfunction at baseline and 12 months.
• However, the fully-adherent cohort experienced a slower rate of increase in extra-nasal symptom scores (0.12 vs 1.29 points/6 months) and ear/facial symptoms (1.17 vs 3.05 points/6 months).

Conclusions:

• Despite potentially worse initial symptom severity, higher adherence to postoperative follow-up is associated with a slower return of symptoms in extra-rhinological and ear-facial domains.
• These findings suggest that patient adherence and clinical management strategies play a significant role in the long-term evolution of outcomes after ESS.
• Optimizing follow-up adherence may be key to improving sustained QOL post-surgery.