{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:22:12Z","timestamp":1760955732924,"version":"3.37.3"},"reference-count":72,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,8,16]],"date-time":"2017-08-16T00:00:00Z","timestamp":1502841600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Board Committee on Quality at the Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>The number of surgical procedures performed for frontal sinusitis and the associated costs have increased dramatically over the past decade. The purpose of this study was to evaluate the cost\u2010effectiveness of endoscopic frontal sinusotomy (EFS) in patients with chronic rhinosinusitis with nasal polyposis (CRSwNP).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Cohort\u2010style Markov decision\u2010tree economic model with a 36\u2010year time horizon.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Matched cohorts of CRSwNP patients who underwent endoscopic sinus surgery (ESS) with (n = 139) and without (n = 49) EFS were compared to each other and to patients (n = 139) from the Medical Expenditures Survey Panel database who underwent medical management for chronic rhinosinusitis. Multi\u2010year health utility values were calculated from responses to the EuroQol 5\u2010Dimension instrument. The primary outcome measure was the incremental cost\u2010effectiveness ratio (ICER).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Decision analysis showed that ESS without EFS proved more cost\u2010effective than ESS with EFS or medical management. ESS without EFS compared to medical management yielded an ICER of $9,004\/quality\u2010adjusted life year (QALY). ESS with EFS compared to ESS without EFS yielded an ICER of $62,310\/QALY. At a willingness\u2010to\u2010pay (WTP) threshold of $50,000\/QALY, ESS without EFS was more cost\u2010effective than ESS with EFS with 52.1% certainty. These results were robust to one\u2010way analysis and probabilistic sensitivity analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>ESS remains a cost\u2010effective intervention compared to medical therapy alone for patients with CRSwNP. In this study, the addition of frontal sinusotomy during ESS for patients with CRSwNP was not found to be cost\u2010effective at a WTP threshold of $50,000\/QALY, but may be cost effective at a higher threshold of $100,000\/QALY.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2c. <jats:italic>Laryngoscope<\/jats:italic>, 128:43\u201351, 2018<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.26783","type":"journal-article","created":{"date-parts":[[2017,8,17]],"date-time":"2017-08-17T07:41:55Z","timestamp":1502955715000},"page":"43-51","source":"Crossref","is-referenced-by-count":9,"title":["The value of frontal sinusotomy for chronic rhinosinusitis with nasal polyps\u2014A cost utility analysis"],"prefix":"10.1002","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6687-788X","authenticated-orcid":false,"given":"George A.","family":"Scangas","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Harvard Medical School Boston Massachusetts"},{"name":"Department of Otolaryngology Massachusetts Eye and Ear Infirmary Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0489-0181","authenticated-orcid":false,"given":"Ashton E.","family":"Lehmann","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Harvard Medical School Boston Massachusetts"},{"name":"Department of Otolaryngology Massachusetts Eye and Ear Infirmary Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron K.","family":"Remenschneider","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Harvard Medical School Boston Massachusetts"},{"name":"Department of Otolaryngology Massachusetts Eye and Ear Infirmary Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3525-8728","authenticated-orcid":false,"given":"Brooke M.","family":"Su","sequence":"additional","affiliation":[{"name":"School of Medicine University of California\u2013San Francisco San Francisco California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3546-9867","authenticated-orcid":false,"given":"Mark G.","family":"Shrime","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Harvard Medical School Boston Massachusetts"},{"name":"Program in Global Surgery and Social Change Harvard Medical School Boston Massachusetts"},{"name":"Department of Otolaryngology Massachusetts Eye and Ear Infirmary Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralph","family":"Metson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Harvard Medical School Boston Massachusetts"},{"name":"Department of Otolaryngology Massachusetts Eye and Ear Infirmary Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,8,16]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_6_2_1","DOI":"10.1177\/00034894041130S502"},{"doi-asserted-by":"publisher","key":"e_1_2_6_3_1","DOI":"10.1002\/lary.25180"},{"doi-asserted-by":"publisher","key":"e_1_2_6_4_1","DOI":"10.1016\/S0194-59989870313-4"},{"doi-asserted-by":"publisher","key":"e_1_2_6_5_1","DOI":"10.1002\/alr.21315"},{"doi-asserted-by":"publisher","key":"e_1_2_6_6_1","DOI":"10.1002\/lary.25054"},{"doi-asserted-by":"publisher","key":"e_1_2_6_7_1","DOI":"10.1007\/s11882-010-0175-2"},{"doi-asserted-by":"publisher","key":"e_1_2_6_8_1","DOI":"10.1016\/j.otc.2010.03.001"},{"doi-asserted-by":"publisher","key":"e_1_2_6_9_1","DOI":"10.1016\/j.otohns.2004.03.022"},{"doi-asserted-by":"publisher","key":"e_1_2_6_10_1","DOI":"10.1002\/lary.20168"},{"doi-asserted-by":"publisher","key":"e_1_2_6_11_1","DOI":"10.1002\/lary.20632"},{"doi-asserted-by":"publisher","key":"e_1_2_6_12_1","DOI":"10.1002\/lary.24335"},{"doi-asserted-by":"publisher","key":"e_1_2_6_13_1","DOI":"10.1177\/0003489415573959"},{"doi-asserted-by":"publisher","key":"e_1_2_6_14_1","DOI":"10.1016\/j.otc.2016.03.024"},{"doi-asserted-by":"publisher","key":"e_1_2_6_15_1","DOI":"10.1377\/hlthaff.2010.0647"},{"doi-asserted-by":"publisher","key":"e_1_2_6_16_1","DOI":"10.1377\/hlthaff.2012.1176"},{"doi-asserted-by":"publisher","key":"e_1_2_6_17_1","DOI":"10.1002\/alr.21726"},{"doi-asserted-by":"publisher","key":"e_1_2_6_18_1","DOI":"10.2500\/ajr.2007.21.2979"},{"doi-asserted-by":"publisher","key":"e_1_2_6_19_1","DOI":"10.1002\/lary.24715"},{"doi-asserted-by":"publisher","key":"e_1_2_6_20_1","DOI":"10.1177\/0194599814529536"},{"key":"e_1_2_6_21_1","first-page":"183","article-title":"Staging in rhinosinusitus","volume":"31","author":"Lund VJ","year":"1993","journal-title":"Rhinology"},{"doi-asserted-by":"publisher","key":"e_1_2_6_22_1","DOI":"10.1177\/014107689709000803"},{"unstructured":"MEPS HC\u2010079: 2003 full year consolidated data file. 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