Predictors of disease progression after endoscopic sinus surgery in patients with chronic rhinosinusitis

J Laryngol Otol. 2019 Aug;133(8):678-684. doi: 10.1017/S0022215119001245. Epub 2019 Jun 20.

Abstract

Objective: This study aimed to determine the predictors of disease progression after functional endoscopic sinus surgery in patients with chronic rhinosinusitis.

Method: A total of 281 adult chronic rhinosinusitis patients who underwent primary bilateral functional endoscopic sinus surgery between 2007 and 2017 and had at least 12 months of follow-up endoscopic evaluation were examined. Patients were divided into eosinophilic (n = 205) and non-eosinophilic chronic rhinosinusitis groups (n = 76). In order to determine adverse factors, post-operative endoscopic appearance scores were analysed in relation to the pre- and intra-operative findings using multiple regression analyses.

Results: The post-operative course of eosinophilic cases deteriorated over time, like the early period for non-eosinophilic cases. Frontal sinus polyps recurred early in eosinophilic chronic rhinosinusitis. Multivariate analyses indicated young adulthood, asthma, high computed tomography score and frontal sinus polyps as significant adverse predictors.

Conclusion: Early, appropriate estimation of sinonasal conditions appears to be crucial for successful surgical management of chronic rhinosinusitis.

Keywords: Endoscopy; Nasal Surgical Procedures; Paranasal Sinuses; Postoperative Period; Recurrence.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Disease Progression
  • Endoscopy
  • Eosinophils / metabolism*
  • Female
  • Frontal Sinus / pathology*
  • Humans
  • Male
  • Middle Aged
  • Recurrence
  • Retrospective Studies
  • Rhinitis / blood
  • Rhinitis / diagnosis
  • Rhinitis / surgery*
  • Risk Factors
  • Sinusitis / blood
  • Sinusitis / diagnosis
  • Sinusitis / surgery*
  • Young Adult