{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T16:56:01Z","timestamp":1772816161265,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2009,5,1]],"date-time":"2009-05-01T00:00:00Z","timestamp":1241136000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2009,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Although multiple studies have demonstrated that symptoms of chronic rhinosinusitis (CRS) improve after endoscopic sinus surgery (ESS), a systematic large\u2010scale evaluation of specific symptom response has not been performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To analyze the relative effectiveness of surgery in the improvement of individual CRS symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>A literature search of MEDLINE, EMBASE, Web of Science, Cochrane databases, and other Web\u2010based sources from January 1, 1980 through June 1, 2008 was performed. Studies of 20 or more adult patients with CRS that used symptom severity scores to analyze at least 3\u00a0major CRS criteria (facial pressure, nasal obstruction, postnasal discharge, and hyposmia) or 2\u00a0major CRS criteria plus headache were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>Inclusion criteria were met by 21 of 289 ESS studies reviewed. Meta\u2010analysis was conducted for each symptom separately with the standardized difference between the preoperative and postoperative severity scores as the effect size (ES).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 2070 patients with CRS were studied a mean of 13.9\u00a0months after ESS. All symptoms demonstrated improvement compared with their respective preoperative severity scores by an overall ES of 1.19 (95% confidence interval, 0.96 to 1.41; <jats:italic>I<\/jats:italic> <jats:sup>2<\/jats:sup> = 81.7%) using the random\u2010effects model. Nasal obstruction (ES, 1.73) improved the most, with facial pain (ES, 1.13) and postnasal discharge (ES, 1.19) demonstrating moderate improvements. Hyposmia (ES, 0.97) and headache (ES, 0.98) improved the least.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The relative improvements in major CRS symptoms and headache after surgery are similar, with the exception of nasal obstruction, which improves most.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.otohns.2008.12.048","type":"journal-article","created":{"date-parts":[[2009,4,23]],"date-time":"2009-04-23T04:40:10Z","timestamp":1240461610000},"page":"633-639","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":53,"title":["Symptom\u2010specific outcomes of endoscopic sinus surgery: A systematic review"],"prefix":"10.1002","volume":"140","author":[{"given":"Alexander C.","family":"Chester","sequence":"first","affiliation":[{"name":"Department of Medicine Georgetown University Hospital Washington, DC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jastin L.","family":"Antisdel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery St Louis University School of Medicine St Louis MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raj","family":"Sindwani","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery St Louis University School of Medicine St Louis MO"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2009,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e318149224d"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-59989770001-9"},{"key":"e_1_2_9_4_1","first-page":"40","article-title":"Chronic rhinosinusitis and nasal polyposis; 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