Endoscopic sinus surgery improves cognitive dysfunction in patients with chronic rhinosinusitis.

Area of Science:

• Otolaryngology
• Neuroscience
• Medical Outcomes

Background:

• Patients with chronic rhinosinusitis (CRS) exhibit cognitive deficits, though the cause remains unclear.
• Cognitive impairment in CRS is often assessed using the Cognitive Failures Questionnaire (CFQ).

Purpose of the Study:

• To investigate if endoscopic sinus surgery (ESS) improves cognitive deficits in CRS patients by reducing inflammation and disease burden.
• To identify comorbid conditions influencing the likelihood of cognitive improvement after ESS.

Main Methods:

• A multi-institutional, observational study enrolled 247 patients with CRS, with and without nasal polyposis (CRSwNP, CRSsNP).
• Pre- and postoperative cognitive function (CFQ), quality of life (RSDI, SNOT-22), and disease severity were assessed.
• The Patient Health Questionnaire (PHQ-2) screened for comorbid depressive disorder.

Main Results:

• Overall, 141 patients showed significant improvement in average CFQ scores post-ESS (p=0.012).
• CRSwNP patients reported significant improvements in total CFQ scores and specific domains (p=0.002).
• Depressive disorder was the sole comorbid condition significantly linked to measurable cognitive deficit (p<0.001).

Conclusions:

• Endoscopic sinus surgery (ESS) may provide modest cognitive benefits for patients with chronic rhinosinusitis (CRS).
• Further research is necessary to understand the mechanisms behind CRS-related cognitive decline and its association with depression.