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The fate of CRS sufferers after MMT

FIGURE 3. Posttreatment mean nasal symptom scores within patient groups.

TABLE 3. Endoscopic findings within post-MMT groups

Post-MMT groups

Symptomatic CRS

Resolved CRS

Asymptomatic CRS

Alternate diagnosis

Total

Post-MMT endoscopic examination No evidence of sinus inflammation

13

9

5

9

36

Evidence of sinus inflammation

29

2

15

1

47

Total

42

11

20

10

83

CRS = chronic rhinosinusitis; MMT = maximal medical therapy.

Predictive value of endoscopy Post-MMT endoscopy was considered positive for inflam- mation in 47 of 86 patients (57%) and was significantly correlated with post MMT radiologic inflammation ( p = 0.001) (Table 3). When compared with CT scanning, en- doscopy had a positive predictive value (PPV) of 94% and a negative predictive value (NPV) of 50%, with sensitiv- ity 71% and specificity 86%. Among symptomatic patients (n = 52) PPV was 97% and NPV 41% (sensitivity 69%, specificity 90%, Table 3). Among symptomatic patients with facial pain scores 3 (n = 12) the NPV was 100% (5/5).

underwent surgery. Three were managed with further pred- nisone courses and one with more intensive topical therapy (Fig. 4). Symptom relapse was not related to gender ( χ 2 0.016, p = 0.90), age ( t test, p = 0.28) atopic status ( χ 2 0.28, p = 0.60), history of asthma ( χ 2 0.30, p = 0.58) or presence of polyps ( χ 2 0.064, p = 0.80). It was also not related to pre-MMT SNOT 22 ( p = 0.89) or NSS ( p = 0.71), or post- MMT SNOT-22 ( p = 0.37) or NSS ( p = 0.07). Pre-MMT and post-MMT CT scores were not related ( p = 0.42 and 0.31, respectively) and neither was history of previous ESS ( p = 1.0).

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