{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T17:36:34Z","timestamp":1791999394167,"version":"4.4.0"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2014,9,18]],"date-time":"2014-09-18T00:00:00Z","timestamp":1410998400000},"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":[[2015,1]]},"abstract":"\n Background<\/jats:title>\n Chronic rhinosinusitis (CRS) has been defined as inflammation of the paranasal sinuses lasting at least 12 weeks with corresponding 2 or more \u201ccardinal symptoms\u201d that include: (1) nasal obstruction; (2) thick nasal discharge; (3) facial pain\/pressure; and (4) reduction or loss of sense of smell. Although prior studies have investigated symptoms of CRS after sinus surgery, none have compared the outcomes of these specific symptoms to ongoing medical therapy.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Patients with CRS were prospectively enrolled into a multi\u2010institutional, comparative effectiveness, cohort study. Subjects elected either continued medical management or endoscopic sinus surgery (ESS). Baseline characteristics and objective clinical findings were collected. Cardinal symptoms of CRS were operationalized by 4 questions on the 22\u2010item Sino\u2010Nasal Outcome Test (SNOT\u201022). Symptom improvement was evaluated in subjects with at least 6\u2010month follow\u2010up.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 342 subjects were enrolled, with 69 (20.2%) electing continued medical management, whereas 273 (79.8%) elected ESS. Subjects electing surgical therapy were more likely to have a higher baseline aggregate SNOT\u201022 score (44.3 (18.9) vs 53.6 (18.8);\n p<\/jats:italic>\n < 0.001). All subjects improved across all cardinal symptoms; however, subjects undergoing ESS were significantly more likely (\n p<\/jats:italic>\n \u2264 0.013) to experience improvement in thick nasal discharge (odds ratio [OR] = 4.36), facial pain\/pressure (OR = 3.56), and blockage\/congestion of nose (OR = 2.76). Subjects with nasal polyposis were significantly more likely to report complete resolution of smell\/taste following ESS compare to medical management (23.8% vs 4.0%;\n p<\/jats:italic>\n = 0.026).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Across a large population, surgical management is more effective at resolving the cardinal symptoms of CRS than ongoing medical management with the exception of sense of smell\/taste.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/alr.21410","type":"journal-article","created":{"date-parts":[[2014,9,18]],"date-time":"2014-09-18T11:17:27Z","timestamp":1411039047000},"page":"36-45","source":"Crossref","is-referenced-by-count":65,"title":["Investigation of change in cardinal symptoms of chronic rhinosinusitis after surgical or ongoing medical management"],"prefix":"10.1002","volume":"5","author":[{"given":"Adam S.","family":"DeConde","sequence":"first","affiliation":[{"name":"Department of Surgery Division of Otolaryngology\u2013Head and Neck Surgery University of California San Diego San Diego CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jess C.","family":"Mace","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Division of Rhinology Oregon Health and Science University Portland OR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremiah A.","family":"Alt","sequence":"additional","affiliation":[{"name":"Division of Head and Neck Surgery Rhinology\u2013Sinus and Skull Base Surgery Program Department of Surgery University of Utah Salt Lake City UT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary M.","family":"Soler","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Division of Rhinology and Sinus Surgery Medical University of South Carolina Charleston SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard R.","family":"Orlandi","sequence":"additional","affiliation":[{"name":"Division of Head and Neck Surgery Rhinology\u2013Sinus and Skull Base Surgery Program Department of Surgery University of Utah Salt Lake City UT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy L.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Division of Rhinology Oregon Health and Science University Portland 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