{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T19:39:26Z","timestamp":1789241966554,"version":"build-2803163510"},"reference-count":26,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2020,7,8]],"date-time":"2020-07-08T00:00:00Z","timestamp":1594166400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Although significant experience has been gained in the technical nuances of endoscopic sinus surgery procedures, the patient-reported outcomes of frontal endoscopic sinus surgery procedures are still poorly understood. In this study we used the validated patient outcome measure Sino Nasal Outcome Test-22 (SNOT-22) to assess the preoperative and postoperative quality of life in patients undergoing extended endoscopic frontal sinus surgery (Draf type 2 and Draf type 3 procedures). Methods: Out of a total of 680 patients undergoing endoscopic sinus and skull base surgery and 186 patients undergoing frontal sinus surgery, 99 chronic rhinosinusitis patients with (CRSwNP) or without (CRSnNP) nasal polyps undergoing Draf 2 or Draf 3 were assessed. Results: The mean preoperative SNOT-22 was 45.6 points for patients undergoing Draf 2 and 59 for patients undergoing Draf 3, while the mean radiological Lund\u2013Mackay Score was 14.3 and 14.5, respectively. Mean SNOT 22 improvement was 22.9 points for Draf 2 and 37 points for Draf 3 respectively and remained significant in all time intervals, including at 4 years after surgery. With the exception of loss of smell\/taste, all symptoms improved by a far bigger extent in Draf 3 group, despite the considerably worse starting point. Effect size (Cohen \/ Standard Deviations) of Draf 3 was greatest in the following symptoms: \u201cbeing frustrated\/restless\/irritable\u201d (1.63), \u201cnasal blockage\u201d (1.43), \u201creduced concentration\u201d (1.35), \u201cfatigue\u201d (1.29) \u201crunny nose\u201d (1.26) and \u201cneed to blow nose\u201d (1.17). Frontal sinus (neo) ostium was patent (fully or partly) at last follow up in 98% of Draf 2 patients and in 88% of patients following Draf 3. Patients with non-patent frontal (neo-) ostium however had a mean postoperative SNOT 22 score of 43 compared to 20 of those with patent frontal sinus (neo-) ostium, although the difference was not statistically significant. Conclusion: Patients undergoing Draf 3 have a greater burden of disease, including both nasal and emotional\/general symptoms compared to Draf 2 patients; surgery results in improvement in both groups, although Draf 3 patients have the greatest benefit, especially in emotional \/ general symptons. In this way both groups achieve similar postoperative quality of life, despite the different starting points.<\/jats:p>","DOI":"10.3390\/jcm9072145","type":"journal-article","created":{"date-parts":[[2020,7,10]],"date-time":"2020-07-10T09:45:31Z","timestamp":1594374331000},"page":"2145","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Quality of Life Outcomes in Frontal Sinus Surgery"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1158-020X","authenticated-orcid":false,"given":"Christos","family":"Georgalas","sequence":"first","affiliation":[{"name":"Department of Surgery\u2014Head and Neck, Medical School, University of Nicosia, Nicosia 2408, Cyprus"},{"name":"Endoscopic Sinus and Skull Base Surgery\u2014Athens (ESA), Hygeia Hospital, Erythrou Stavrou 4, Maroussi, 15123 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marios","family":"Detsis","sequence":"additional","affiliation":[{"name":"Faculty of Mathematics, School of Medicine, European University Cyprus, Diogenis Str 6, Nicosia 2404, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Geramas","sequence":"additional","affiliation":[{"name":"Endoscopic Sinus and Skull Base Surgery\u2014Athens (ESA), Hygeia Hospital, Erythrou Stavrou 4, Maroussi, 15123 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitris","family":"Terzakis","sequence":"additional","affiliation":[{"name":"Endoscopic Sinus and Skull Base Surgery\u2014Athens (ESA), Hygeia Hospital, Erythrou Stavrou 4, Maroussi, 15123 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Liodakis","sequence":"additional","affiliation":[{"name":"Endoscopic Sinus and Skull Base Surgery\u2014Athens (ESA), Hygeia Hospital, Erythrou Stavrou 4, Maroussi, 15123 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,7,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2672","DOI":"10.1002\/lary.21847","article-title":"Health state utility values in patients undergoing endoscopic sinus surgery","volume":"121","author":"Soler","year":"2011","journal-title":"Laryngoscope"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4193\/Rhino12.000","article-title":"EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. 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Forum Allergy Rhinol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/7\/2145\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:48:45Z","timestamp":1760176125000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/7\/2145"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,8]]},"references-count":26,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2020,7]]}},"alternative-id":["jcm9072145"],"URL":"https:\/\/doi.org\/10.3390\/jcm9072145","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,8]]}}}