Smoking and endoscopic sinus surgery: does smoking volume contribute to clinical outcome.

ABSTRACT: The effect of tobacco smoking on chronic rhinosinusitis (CRS) is not yet well-delineated. The purpose of this investigation was to evaluate the overall effect of smoking on postoperative outcomes (endoscopic score and health-related quality-of-life [HRQoL]) after endoscopic sinus surgery (ESS) for CRS and to determine if volume of daily smoking impacts outcomes.A total of 784 patients with CRS were prospectively enrolled between January 2001 and April 2009 after electing ESS from 1 of 3 academic tertiary care centers. Follow-up longer than 6 months was available on 39 smoking patients. Smoking volume (cigarettes/day) analysis was performed by dichotomizing patients into either of 2 subgroups: light smokers (<20 cigarettes per day) or heavy smokers (? 20 cigarettes per day). Primary outcomes were Lund-Kennedy endoscopy scores and 2 disease-specific HRQoL instruments: the Rhinosinusitis Disability Index (RSDI) and Chronic Sinusitis Survey (CSS).Smokers and nonsmokers experienced similar improvement in HRQoL following surgery (RSDI: p = 0.792 and CSS: p = 0.117). No difference in HRQoL improvements between light smokers and heavy smokers was identified. While overall changes in endoscopy scores did not differ between smokers and nonsmokers, there was a significant difference in the prevalence of worsening postoperative endoscopy scores between heavy smokers, light smokers, and nonsmokers (100%, 33%, and 20%, respectively; p = 0.002).Active smoking status does not alter postoperative improvement in HRQoL after ESS. Although limited by a small sample size, increasing smoking volume may contribute to worse postoperative endoscopy scores.

SUBMITTER: Rudmik L 

PROVIDER: S-EPMC3124774 | biostudies-literature | 2011 May-Jun

REPOSITORIES: biostudies-literature