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Evidence-based endoscopic sinus surgery.

Evidence-based medicine principles applied to otolaryngology and endoscopic sinus surgery provide the surgeon, patient, and third-party payer with all of the necessary requirements to evaluate the effectiveness of the surgery. Above all, they ensure long-term improvement in quality of life and patients' satisfaction. A specific study on the outcomes of endoscopic sinus surgery is presented. A longitudinal observational study of 51 patients undergoing endoscopic sinus surgery for recurrent acute rhinosinusitis, chronic rhinosinusitis, and nasal polyposis was done in two hospitals. Patients were evaluated preoperatively and 3 months postoperatively with a disease-specific health status questionnaire (Quebec French-Rhinosinusitis Outcome Measure) and a general health status questionnaire (the Medical Outcome Study 36-Item Short-Form Health Survey). The results show statistically significant improvement in quality of life after endoscopic sinus surgery in both the disease-specific and the disease-generic health status questionnaires. The broader subject of objective and subjective outcomes assessment, along with evidence-based evaluation, is discussed.