The impact of comorbid gastroesophageal reflux disease on endoscopic sinus surgery quality-of-life outcomes.
BACKGROUND
Chronic rhinosinusitis (CRS) and gastroesophageal reflux disease (GERD) are common entities that overlap in patient demographics. The pathophysiologic role of GERD has yet to be elucidated, but it is postulated that extraesophageal reflux may contribute to worsening symptoms of CRS. This study seeks to investigate whether patients with CRS with and without a history of GERD experience comparable quality-of-life (QOL) improvement after endoscopic sinus surgery (ESS).


METHODS
An adult cohort (n = 229) with medically refractory CRS was prospectively assessed following ESS using 3 disease-specific QOL constructs. A patient subset with a history of comorbid GERD was retrospectively identified (n = 72) and preoperative and postoperative QOL were compared to patients without GERD (n = 157).


RESULTS
Patients with comorbid GERD and CRS were comparable across all baseline patient characteristics (p > 0.050) with the exception of patients with a history of GERD; those patients were less likely to have undergone allergy testing (p < 0.002) and were older (53.8 years vs 47.6; p < 0.002). Similarly, baseline objective and subjective measures of disease were comparable between patients with CRS with and without GERD (p > 0.050). Both groups experienced significant QOL improvement across all QOL constructs (p ≤ 0.021), and no difference was detected in the magnitude of that improvement between patients with and without a history of GERD (p > 0.050). Similarly, patients on active medical therapy for GERD (n = 49) had QOL gains comparable to patients not reporting GERD medical therapy (p > 0.050).


CONCLUSION
Patients electing ESS for CRS with and without comorbid GERD have comparable baseline characteristics and QOL outcomes following surgery.
['DeConde|Adam S|AS|', 'Mace|Jess C|JC|', 'Smith|Timothy L|TL|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D002908:Chronic Disease D015331:Cohort Studies D004724:Endoscopy D005260:Female D005500:Follow-Up Studies D005764:Gastroesophageal Reflux D006801:Humans D008297:Male D008875:Middle Aged D011446:Prospective Studies D011788:Quality of Life D012220:Rhinitis D012852:Sinusitis D016896:Treatment Outcome D014481:United States D055815:Young Adult
gastroesophageal reflux confounding factors endoscopy outcome assessment quality of life sinusitis