The Impact of Acute Peri-operative Particulate Matter Exposure on Endoscopic Sinus Surgery Outcomes: A Preliminary Multi-site Investigation.
Autor: | Tullis B; Department of Otolaryngology - Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA., Mace JC; Division of Rhinology and Sinus Surgery/Oregon Sinus Center, Department of Otolaryngology - Head and Neck Surgery, Oregon Health & Science University (OHSU), Portland, OR, USA., Hagedorn R; Department of Otolaryngology - Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA., Nguyen C; Department of Otolaryngology - Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA., Stockard R; Department of Otolaryngology - Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA., Massey C; Department of Otolaryngology - Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA., Ramakrishnan VR; Department of Otolaryngology - Head and Neck Surgery, University of Indiana, Indianapolis, IN, USA., Beswick DM; Department of Otolaryngology - Head and Neck Surgery, University of California, Los Angeles, CA, USA., Soler ZM; Department of Otolaryngology -Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA., Smith TL; Division of Rhinology and Sinus Surgery/Oregon Sinus Center, Department of Otolaryngology - Head and Neck Surgery, Oregon Health & Science University (OHSU), Portland, OR, USA., Alt JA; Department of Otolaryngology - Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA., Gill AS; Department of Otolaryngology - Head and Neck Surgery, University of Michigan, Ann Arbor, MI, USA. |
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Jazyk: | angličtina |
Zdroj: | American journal of rhinology & allergy [Am J Rhinol Allergy] 2024 Jul; Vol. 38 (4), pp. 237-244. Date of Electronic Publication: 2024 Apr 16. |
DOI: | 10.1177/19458924241246371 |
Abstrakt: | Background: Environmental exposures have been postulated to play an important role in the pathophysiology of chronic rhinosinusitis (CRS). Particulate matter (PM) is one of the most widely studied ambient air pollutants, but its peri-operative impact on CRS is unknown. Objective: To determine the effect of acute, peri-operative PM exposure on outcomes after endoscopic sinus surgery (ESS). Methods: Participants with CRS who self-selected ESS were prospectively enrolled. The 22-item SinoNasal Outcome Test (SNOT-22) and Medical Outcomes Study Questionnaire Short-Form 6-D (SF-6D) health utility values scores were recorded. Using residence zip codes, a secondary analysis of patient exposure to PM <2.5 μm and <10 μm (PM2.5 and PM10, respectively) was performed for the month of surgery utilizing data from Environmental Protection Agency air quality monitors. Spearman's correlation coefficients (ρ), 95% confidence intervals (CIs), and effect estimates (β) were used to determine the magnitudes of association. Simple, multivariate regression analysis was also completed. Results: One hundred and seven patients from four geographically unique institutions across the US were enrolled with a follow-up of 6 months. Patients with higher peri-operative PM2.5 exposure had less improvement in their SNOT-22 scores after ESS compared to those with less exposure using both univariate analysis (ρ = 0.26, 95% CI: 0.08, 0.43; P = .01) and after covariate adjustment with multivariate analysis ( B = 1.06, 95% CI: 0.001, 2.14, P = .05). Similar associations were not found with SF-6D outcomes or with PM10 as an exposure of interest. No significant correlations were found between peri-operative PM levels and Lund-Kennedy endoscopy scores post-operatively. Conclusion: Preliminary data from this pilot study reveal that PM exposure at the time of ESS may negatively associate with post-operative improvement in sinonasal quality-of-life. Larger, population-based studies with more standardized PM exposure windows are needed to confirm the clinical significance of the present findings. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: D.M.B: Grant support from CF Foundation and from the International Society of Inflammation and Allergy of the Nose, unrelated to this work. Garner Health, consultant, equity. Honoraria from Rockpointe and Trinity Sciences. J.A.A: GlycoMira consultant, equity. GSK speaker panel. OptiNose consultant, Medtronic consultant. Z.M.S: Lyra, Optinose, Regeneron consultant. Medical director Healthy Humming. |
Databáze: | MEDLINE |
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