Quality Improvement in Chronic Rhinosinusitis
Quality improvement (QI) in CRS is garnering increasing attention. CRS is one of the most common of chronic diseases, and the management of CRS is known to have wide variability between geographic regions and providers. However, robust QI programs are rare nationwide. In conjunction with the American Rhinologic Society QI committee, the UVA Rhinology division is striving to understand the barriers to effective QI in CRS and to implement feasible solutions that promote high quality of care for all CRS patients.
A brief version of the questionnaire of olfactory disorders in patients with chronic rhinosinusitis
Using less than half of the questions in the Questionnaire of Olfactory Disorders-Negative Statements (QOD-NS), excellent correlations with both total and domain-specific scores are achieved. A brief version of the QOD-NS may prove useful in future clinical and research settings.
Long-term outcomes of endoscopic sinus surgery in the management of adult chronic rhinosinusitis
Ten-year prospective outcomes of ESS for CRS demonstrate that the initial clinically significant improvements in QOL seen 6 months postoperatively are durable over the long term. Over 75% of patients reported clinically significant long-term QOL and HUV improvement. HUV returned to normal. Revision surgery rate was 17% and worse postoperative endoscopy scores within 18 months of initial ESS were associated with higher likelihood of revision surgery. Most patients would pursue ESS again and recommend the procedure to other patients considering this treatment option.
Symptom Importance, Patient Expectations, and Satisfaction in CRS
Nasal, smell, and sleep-related symptoms were consdidered most important by this cohort. Meeting of preoperative expectations, improvement of the most important symptoms, and the magnitude of change in the SNOT-22 may drive postoperative satisfaction.
Establishing the minimal clinically important difference for the Questionnaire of Olfactory Disorders
The distribution‐based minimal clinically important difference (MCID) value determinations of the Questionnaire of Olfactory Disorders Negative Statements (QOD‐NS) survey instrument range between 2.6 to 8.6 points, with an average value of 5.2. Once stratified by normal vs abnormal QOD‐NS scores at baseline, the majority of patients with abnormal preoperative QOD‐NS achieve an MCID in olfactory‐specific QOL. A better understanding of why some patients perceive improved olfactory QOL and prognostic factors is needed.
Taste impairment in chronic rhinosinusitis
Taste dysfunction is a common complaint in CRS. This cohort shows prevalence of gustatory loss to be about 28% using ideal normative values. This dysfunction correlated with male gender, smoking history, and older age. Taste dysfunction did not correlate with measured olfactory outcomes.