Author(s)
Maryann Zhao, MD
Allen S. Zhou, MD
Ralph Metson, MD
Stacey T. Gray, MD
Affiliation(s)
Mass Eye and Ear
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to recognize the effect of diabetes mellitus on long-term sinonasal symptoms and general quality of life in chronic rhinosinusitis patients who underwent endoscopic sinus surgery.
Objectives: To evaluate the impact of diabetes mellitus on symptom burden and general health related quality of life in patients who undergo endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS).
Study Design: Prospective observational cohort study.
Methods: Patients with CRS completed the 22 item Sino-Nasal Outcome Test (SNOT-22) and EuroQol 5 dimension survey (EQ-5D) preoperatively and at 3 months, 1 year, 2 years, 3 years and 4 years following ESS. Comparisons of SNOT-22 and EQ-5D scores by diabetes status were performed with t-tests and linear regression.
Results: Among the 1307 patients enrolled in the study, 81 [6%] had diabetes. Both diabetic and non-diabetic patients experienced significant reductions in SNOT-22 scores from baseline at all postoperative timepoints (P less than 0.05), with no significant differences between groups at any followup interval. In contrast, EQ-5D scores were significantly higher in non-diabetic patients at baseline and all postoperative time points (all P less than 0.05). Among diabetic patients, significant improvement from baseline in EQ-5D was observed only at the 2 year followup, whereas non-diabetic patients showed consistent improvement at all timepoints.
Conclusions: ESS is associated with sustained symptom improvement in patients with and without diabetes. However, patients with diabetes may experience attenuated gains in overall quality of life compared to non-diabetic patients, particularly beyond the second postoperative year. These findings support the utility of long-term monitoring and individualized counseling for diabetic patients undergoing ESS.