Long-Term Clinical Follow-Up of Patients With Chronic Rhinosinusitis

Ann Otol Rhinol Laryngol. 2021 May;130(5):504-512. doi: 10.1177/0003489420962822. Epub 2020 Oct 1.

Abstract

Objective: This study comprised a long-term follow-up of a cohort of patients with chronic rhinosinusitis (CRS) regarding clinical features and symptomatology.

Methods: Data from 42 patients with CRS were available from a previous study. Forty of these patients were alive and were contacted for inclusion after approximately 10 years. Patients completed a questionnaire about disease and symptoms, and underwent a clinical examination.

Results: Thirty-four patients (85%) responded and could be included and evaluated. For the participants in this follow-up study median length of time between initial inclusion (C1) and follow-up (C2) was 11 years (range: 8-15). In some patients the CRS shifted phenotype over time, from CRS with nasal polyposis to CRS without nasal polyposis or vice versa. The median total visual analogue score for combined sinonasal symptoms for all patients was statistically significantly reduced at follow-up. For individual patients, scores for nasal congestion, nasal discharge, facial pressure, and hyposmia were also statistically significantly reduced. The most frequently reported symptom-relieving treatments were nasal steroids and saline rinsing of the nose. Self-reported general quality of life was statistically significantly improved at C2 compared to C1.

Conclusion: At long-term follow-up, symptoms were generally reduced and patients reported an improved quality of life. Patients can be given hope for eventual symptom relief. CRS is a chronic condition that seems to harbor the ability to alter its phenotype after several years. Topical corticosteroids and saline rinsing of the nose should be emphasized, since patients consider these treatments to be of high value.

Keywords: follow-up; prognosis; quality of life; rhinosinusitis; treatment.

MeSH terms

  • Administration, Intranasal
  • Anosmia* / diagnosis
  • Anosmia* / etiology
  • Chronic Disease
  • Female
  • Follow-Up Studies
  • Glucocorticoids / administration & dosage*
  • Humans
  • Male
  • Middle Aged
  • Nasal Polyps* / diagnosis
  • Nasal Polyps* / etiology
  • Quality of Life*
  • Rhinitis* / epidemiology
  • Rhinitis* / physiopathology
  • Rhinitis* / psychology
  • Rhinitis* / therapy
  • Sinusitis* / epidemiology
  • Sinusitis* / physiopathology
  • Sinusitis* / psychology
  • Sinusitis* / therapy
  • Sweden / epidemiology
  • Symptom Assessment / methods
  • Symptom Assessment / statistics & numerical data
  • Time
  • Treatment Outcome
  • Visual Analog Scale

Substances

  • Glucocorticoids