{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T11:51:53Z","timestamp":1791978713029,"version":"4.4.0"},"reference-count":10,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2012,6,26]],"date-time":"2012-06-26T00:00:00Z","timestamp":1340668800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2013,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background:<\/jats:title><jats:p>This study evaluated 1\u2010year outcomes in patients with chronic rhinosinusitis (CRS) who were considered surgical candidates by study criteria and elected either medical management or endoscopic sinus surgery (ESS). In addition, some patients initially enrolled in the medical treatment arm crossed over to the surgery arm during the study period and their respective outcomes are evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>Adult subjects with CRS who failed initial medical therapy were prospectively enrolled into a nonrandomized, multi\u2010institutional cohort. Subjects were included in 1 of 3 cohorts: medically managed, surgically managed, or crossover (from medical to surgical). The primary outcome measure was disease\u2010specific quality\u2010of\u2010life (QOL). Bivariate and multivariate analyses compared QOL improvement between cohort groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>Baseline comorbidity, QOL, and other disease severity measures were not different between the 3 cohorts. With 1\u2010year follow up, surgical patients (n = 65) reported significantly more improvement than medically managed patients (n = 33; Rhinosinusitis Disability Index (RSDI), <jats:italic>p<\/jats:italic> = 0.039; Chronic Sinusitis Survey (CSS), <jats:italic>p<\/jats:italic> = 0.018). Seventeen subjects who had initially elected medical management crossed over to surgery during the follow\u2010up period. QOL in the crossover cohort was initially stagnant or worsening followed by improvement after ESS (RSDI, <jats:italic>p<\/jats:italic> = 0.035; CSS, <jats:italic>p<\/jats:italic> = 0.070). At 1\u2010year follow\u2010up, higher frequency of improvement was found in the surgical cohort vs medical cohort for several outcomes (total CSS: 70.8% vs 45.5%; odds ratio [OR], 3.37; 95% confidence interval [CI], 1.27\u20108.90; <jats:italic>p<\/jats:italic> = 0.014).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion:<\/jats:title><jats:p>With 1 year of follow\u2010up, patients electing ESS experienced significantly higher levels of improvement in outcomes compared to patients managed by medication alone. In addition, a crossover cohort who initially elected medical management experienced improvement in several outcomes after crossing over to ESS. \u00a9 2013 ARS\u2013AAOA, LLC.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.21065","type":"journal-article","created":{"date-parts":[[2012,6,27]],"date-time":"2012-06-27T04:38:25Z","timestamp":1340771905000},"page":"4-9","source":"Crossref","is-referenced-by-count":123,"title":["Medical therapy vs surgery for chronic rhinosinusitis: a prospective, multi\u2010institutional study with 1\u2010year follow\u2010up"],"prefix":"10.1002","volume":"3","author":[{"given":"Timothy L.","family":"Smith","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Kern","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James N.","family":"Palmer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodney","family":"Schlosser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakesh K.","family":"Chandra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander G.","family":"Chiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Conley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jess C.","family":"Mace","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongwei F.","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Stankiewicz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,6,26]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/alr.20063"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2007.06.726"},{"key":"e_1_2_7_4_2","first-page":"183","article-title":"Staging in rhinosinusitis","volume":"31","author":"Lund VJ","year":"1993","journal-title":"Rhinology"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-59989770005-6"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1997.01900110025004"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-199504000-00010"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.MLR.0000062554.74615.4C"},{"key":"e_1_2_7_9_2","doi-asserted-by":"crossref","DOI":"10.1002\/0471722146","volume-title":"Applied Logistic Regression","author":"Hosmer DW","year":"2000"},{"key":"e_1_2_7_10_2","first-page":"CD004458","article-title":"Functional endoscopic sinus surgery for chronic rhinosinusitis","volume":"19","author":"Khalil HS","year":"2006","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2009.01.030"}],"container-title":["International Forum of Allergy &amp; Rhinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Falr.21065","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/alr.21065","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T01:11:24Z","timestamp":1696986684000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/alr.21065"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,6,26]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2013,1]]}},"alternative-id":["10.1002\/alr.21065"],"URL":"https:\/\/doi.org\/10.1002\/alr.21065","archive":["Portico"],"relation":{},"ISSN":["2042-6976","2042-6984"],"issn-type":[{"value":"2042-6976","type":"print"},{"value":"2042-6984","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,6,26]]}}}