Thesis defence in the University of Oulu

Doctoral Candidate

Licentiate of Medicine Antti Alakärppä

Faculty and research unit

University of Oulu Graduate School, Faculty of Medicine, Otorhinolaryngology -Head and Neck Surgery/PEDEGO

Field of study

Otorhinolaryngology - Head and Neck Surgery

Date and time of the thesis defence

24.5.2019 12:00

Place of the thesis defence

Auditorium F202, Faculty of Medicine, Aapistie 5B, Oulu

Topic of the dissertation

Primary sinonasal surgery and health-related quality of life in adults

Opponent

Docent Jura Numminen, Tampere University Hospital

Custos

Professor Olli-Pekka Alho, University of Oulu, Department of Otorhinolaryngology - Head and Neck Surgery / PEDEGO

The effect of nasal surgery on quality of life

Surgery can improve quality of life of a patient who suffers from deviated nasal septum or sinus infections

This thesis discovered that a deviated nasal septum or sinus infections lowered a patient’s quality of life, and surgery on these conditions improved quality of life nearly to the level of normal population. Previously, it has been noted that some factors, such as patient’s asthma or revision surgery affect the quality of life outcomes after surgery. This study found that the best predictor of a benefit of surgery to the patient was the preoperative detriment of quality of life.

In Finland, some 1700 nasal septal deviation surgeries (septoplasties) and 3200 surgeries on infected sinuses (Endoscopic sinus surgeries) are done annually. These illnesses or surgeries cause very rarely any mortality or severe complications, so noting and improving the quality of life are important goals of the surgeries. Quality of life is measured with generic health-related or disease-specific questionnaires. Quality of life measuring instruments have been in used in ear, nose and throat diseases since the 1990’s, but in evince-based medicine databases, their use has increased only in the 2000’s.

The thesis is composed of a systematic literature review and a patient cohort. The systematic review was performed on a scientific evidence-based medicine Cochrane database of ear, nose and throat surgery trials. The goal was to explore the inclusion of quality of life aspects in the studies. The patient cohort consisted of 160 adults, who underwent septoplasty or endoscopic sinus surgery in Oulu university hospital. The quality of life was followed up before surgery and one year after the operation using a disease-specific and two generic health-related questionnaires. The patient cohort was compared to an age- and gender-matched control cohort that was followed up simultaneously.

Assessing the quality of life and its change after treatments makes it possible to incorporate the views of a patient and to measure it. Based on the results of the study, a disease-specific quality of life questionnaire can be recommended to be used in clinical work in endoscopic sinus surgery. Economic constraints mandate the measurements of effectiveness of treatments, and the pivotal role of quality of life in surgery of nasal septum and sinuses requires that it is considered.

Dissertation

Last updated: 17.5.2019