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Predicting revision sinus surgery in allergic fungal and eosinophilic mucin chronic rhinosinusitis

Ramzi T Younis1, Jamal Ahmed2

  • 1Division of Pediatric Otolaryngology, Department of Otolaryngology-Head & Neck Surgery, University of Miami, Miami, Florida, U.S.A.

The Laryngoscope
|September 1, 2016
PubMed
Abstract

Insights

Eosinophilic mucin in chronic rhinosinusitis is linked to more revision surgeries. Identifying this factor can help predict and manage patients needing repeat surgical interventions for allergic fungal sinusitis and EMCRS.

Area of Science:

  • Otolaryngology
  • Surgical Pathology

Background:

  • Chronic rhinosinusitis (CRS) encompasses diverse pathologies, including eosinophilic mucin, a hallmark of allergic fungal sinusitis (AFS) and eosinophilic mucin chronic rhinosinusitis (EMCRS).
  • These CRS subtypes often necessitate surgical management and are associated with high rates of recurrence, leading to potential repeat surgeries.

Purpose of the Study:

  • To identify clinical factors associated with a higher likelihood of revision surgeries in patients diagnosed with AFS or EMCRS.
  • To test the hypothesis that polyps, high Lund-Mackay scores (LMS), and fungal presence correlate with increased revision surgery rates.

Main Methods:

  • Retrospective cohort study analyzing 117 patients diagnosed with AFS or EMCRS between 2005 and 2009.
  • Contingency tables and odds ratios with 95% confidence intervals were used to assess the association between clinical predictors and the need for revision surgery.

Main Results:

  • Twenty-two percent (26/117) of patients required revision surgery within the study period.
  • Patients undergoing revision surgery had a slightly higher average Lund-Mackay score (16 vs. 13).
  • The presence of eosinophilic mucin was significantly associated with a higher rate of revision surgery.

Conclusions:

  • The presence of eosinophilic mucin is a significant predictor of higher revision surgery rates in patients with AFS and EMCRS.
  • Further research may focus on targeted medical or surgical strategies for patients with eosinophilic mucin to reduce recurrence.
Keywords:
Allergic fungal sinusitis (AFS)Lund-Mackay score (LMS)eosinophilic mucin chronic rhinosinusitis (EMCRS)

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