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patient-centered definitions of commonly used terms. For example, there is no clear definition of what an optimal surgical outcome after ESS is, partly because even experienced clinicians do not fully understand each patient’ perspective and overall experience. There is also no unique agreed-upon definition for an “acute exacerbation” of CRS, as Wu et al. showed in their systematic review published last year [8]. It is exceedingly complex to perfectly pinpoint why each patient wishes to undergo surgery for CRS, but perhaps there are common themes. More and more, effort in research in put towards defining important concepts in Rhinology and developing clinical recommendations based on evidence. Last year, the Rhinology Subspecialty group of the Canadian Society of Otolaryngology – Head & Neck Surgery published recommendations for the diagnosis and treatment of acute rhinosinusitis and nasal fracture through the Choosing Wisely Canada campaign [9]. This initiative is primarily aimed at reducing unnecessary tests and treatments, by giving clinicians the tools to assist patients in shared decision-making. With improving surgical techniques and novel medical therapy, the outcomes of CRS patients have steadily been improving. That said, there remains a small subset of patients who do not experience a significant improvement in their CRS symptoms postoperatively, or who only get a short-lived improvement in their QoL [10]. An in-depth understanding of patients’ experiences and views is paramount to the patient-physician partnership. Being familiar with patients’ journey would help clinicians improve their therapeutic relationships with patients, identify causes for dissatisfaction and predict post-operative disappointment. This study aims to broadly further our understanding of patients’ experiences and views on CRS and ESS. A qualitative research methods was chosen for this study. Gallo et al. state that “this type of research has the potential to enhance the understanding of surgeons’ and patients’ preferences, attitudes and beliefs, as well as assess how these may change with time” [11]. Study methodology and findings are reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) [12]. A phenomenological methodological orientation was used; namely, the focus of the study was on individual subjective experiences. Three themes were identified a priori and incorporated into the interview template: living with CRS, objectives and expectations and criteria for success. Informed written consent was obtained from all participants before entry into the study. This study was approved by the University of Montreal Healthcare Center Institutional Review Board and was conducted following study protocol and the principles of the Declaration of Helsinki. Setting Twenty-two participants were recruited from a single surgeon’s tertiary care practice (Rhinology & Skull Base Surgery) between August 2018 and January 2019 at the University of Montreal Healthcare Center (CHUM) clinic of Otolaryngology – Head & Neck Surgery. Participants were adult patients (≥ 18 years old) with either CRSwNP (Chronic Rhinosinusitis with Nasal Polyposis) or CRSsNP (Chronic Rhinosinusitis without Nasal Polyposis) who had undergone at least one ESS. Patient charts were accessed before the start of clinic to determine eligibility. Participants were purposively approached face-to-face before their scheduled appointment in the waiting room. Interviews were conducted either before or after their visit, depending on clinical workflow. Before initiating interviews, the interviewer explained to patients he had training as a physician but was not part of the medical team. Short-term and long-term objectives of our study were explained to participants; it was stated that data would be used for scientific research, rather than for internal audit purposes. A total of 27 patients were approached, only 3 declined to participate. In all 3 cases, it was because their schedule did not permit it. Interview Interviews were conducted in a semi-structured, face-to-face manner by NS (male), who at the time of the study held a Medical Degree and was enrolled in a full-time Masters’ Degree in Biomedical Science (Clinical Research) at the University of Montreal. Interviews were scheduled to last 15 min. Based on a review of literature, an interview template composed of 8 open-ended questions was produced [13,14,15,16]. An iterative process was conducted throughout interviews to remove low-yield questions or add prompts; the final version is shown in Appendix 1. Specific prompts were added to stimulate discussion and provide a structure. Moreover, this allowed participants to provide impressions they had not spontaneously mentioned. Each question was
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