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How Does Age Impact Presentation and Outcomes in Chronic Rhinosinusitis?
Thomas Holmes1,2, Chadi Makary1,2, Aykut A Unsal1,2
1Department of Otolaryngology - Head and Neck Surgery, Medical College of Georgia, Augusta University, Augusta, GA, USA.
The Annals of Otology, Rhinology, and Laryngology
|May 12, 2020
Summary
Young adults with chronic rhinosinusitis (CRS) report higher symptom burden, despite similar objective disease severity compared to older adults. Surgical outcomes and long-term improvement are consistent across all age groups.
Area of Science:
- Otolaryngology
- Rhinology
- Surgical Outcomes Research
Background:
- Chronic rhinosinusitis (CRS) prognosis is linked to eosinophilia and nasal polyps.
- The impact of patient age on CRS outcomes requires further investigation.
Purpose of the Study:
- To evaluate the influence of age on chronic rhinosinusitis (CRS) presentation and surgical outcomes.
- To determine if age modifies the prognostic significance of eosinophilia and nasal polyps in CRS.
Main Methods:
- Retrospective review of 431 CRS patients undergoing primary surgery.
- Patients stratified by age: young adults (18-39), adults (40-64), and elderly (65+).
- Comparison of Sinonasal Outcome Test (SNOT-22), Lund-Kennedy (LK) endoscopy, and Lund-McKay (LM) CT scores pre- and post-operatively over 5 years.
Main Results:
- Young adults presented with significantly higher SNOT-22 scores and rhinologic symptom scores.
- Objective disease severity (LK scores) was significantly higher in young adults at 1-year post-surgery.
- No significant differences in tissue eosinophilia, nasal polyposis, or preoperative CT scores across age groups.
Conclusions:
- Young adults with CRS experience a greater subjective symptom burden compared to older patients.
- Surgical treatment for CRS yields comparable short- and long-term improvements across all age demographics.
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