{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T10:51:12Z","timestamp":1761562272468,"version":"3.37.3"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,8,4]],"date-time":"2017-08-04T00:00:00Z","timestamp":1501804800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["R01 DC005805"],"award-info":[{"award-number":["R01 DC005805"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Medically refractory chronic rhinosinusitis (CRS) can be managed with appropriate continued medical therapy (CMT) or surgery followed by CMT. Patients who initially elect CMT and do not experience adequate symptom resolution may \u201ccross over\u201d to endoscopic sinus surgery (ESS). Our objective was to identify patient covariates associated with this subset of patients who elect this change in treatment modality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective analysis of a prospective, multi\u2010center cohort of adult patients with CRS enrolled between March 2011 and June 2015 in academic, tertiary referral clinics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Subjects who initially elected CMT were followed up to 18 months, provided a comprehensive medical history, and completed the 22\u2010item SinoNasal Outcome Test (SNOT\u201022) at baseline and during 6\u2010month follow\u2010up intervals. Hazard regression modeling was used to identify covariates associated with elective change in treatment modality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred seventy\u2010nine subjects were followed for an average 15.1 (standard deviation \u00b1 4.6) months. Subjects who elected ESS (55 of 179) had significantly worse average endoscopy scores and reported worse SNOT\u201022 sleep dysfunction scores at baseline (<jats:italic>P<\/jats:italic> \u2264 0.026). For each single increasing (worsening) point of Lund\u2010Kennedy endoscopy score, the hazard ratio (HR) of crossover increased by \u223c6%. Similarly, for every point of worsening in baseline SNOT\u201022 total score, the hazard of treatment crossover increased by \u223c2%. After covariate adjustment, only baseline SNOT\u201022 sleep dysfunction scores were associated with an increased risk of treatment crossover (HR = 1.07; 95% confidence interval: 1.02\u20131.11; <jats:italic>P<\/jats:italic> = 0.003).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Baseline total SNOT\u201022 and endoscopy scores are associated with treatment crossover, but reported sleep dysfunction is the only significant independent predictor of treatment crossover.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2c. <jats:italic>Laryngoscope<\/jats:italic>, 128:304\u2013310, 2018<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.26788","type":"journal-article","created":{"date-parts":[[2017,8,4]],"date-time":"2017-08-04T11:26:36Z","timestamp":1501845996000},"page":"304-310","source":"Crossref","is-referenced-by-count":9,"title":["Analysis of factors associated with electing endoscopic sinus surgery"],"prefix":"10.1002","volume":"128","author":[{"given":"Adam S.","family":"DeConde","sequence":"first","affiliation":[{"name":"Department of Surgery Division of Otolaryngology\u2013Head and Neck Surgery, University of California\u2013San Diego San Diego California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jess C.","family":"Mace","sequence":"additional","affiliation":[{"name":"Division of Rhinology and Sinus\/Skull Base Surgery Oregon Sinus Center, Department of Otolaryngology\u2013Head and Neck Surgery; Oregon Health and Science University Portland Oregon U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vijay R.","family":"Ramakrishnan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Colorado Aurora Colorado U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremiah A.","family":"Alt","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2013Head and Neck Surgery Rhinology\u2013Sinus and Skull Base Surgery Program, Department of Surgery, University of Utah Salt Lake City Utah U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6424-7083","authenticated-orcid":false,"given":"Timothy L.","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of Rhinology and Sinus\/Skull Base Surgery Oregon Sinus Center, Department of Otolaryngology\u2013Head and Neck Surgery; Oregon Health and Science University Portland Oregon U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,8,4]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2009.10.009"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21065"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21410"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24027"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21408"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21721"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21695_c"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2007.06.726"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599815574247"},{"key":"e_1_2_6_11_1","first-page":"183","article-title":"Staging in rhinosinusitus","volume":"31","author":"Lund VJ","year":"1993","journal-title":"Rhinology"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-59989770005-6"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200103000-00008"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21670"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-4486.2009.01995.x"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2014.1045"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21769"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26157"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25108"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21800"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21458"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21721"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21217"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21238"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.MLR.0000062554.74615.4C"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flary.26788","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.26788","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T23:40:47Z","timestamp":1695858047000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.26788"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8,4]]},"references-count":24,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018,2]]}},"alternative-id":["10.1002\/lary.26788"],"URL":"https:\/\/doi.org\/10.1002\/lary.26788","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"type":"print","value":"0023-852X"},{"type":"electronic","value":"1531-4995"}],"subject":[],"published":{"date-parts":[[2017,8,4]]}}}