Predictive factors of revision endoscopic sinus surgery

Area of Science:

• Otolaryngology
• Immunology
• Respiratory Medicine

Background:

• Chronic rhinosinusitis with nasal polyps (CRSwNP) often requires endoscopic sinus surgery (ESS).
• High recurrence rates of nasal polyps post-ESS necessitate identifying predictive factors for revision surgery.

Purpose of the Study:

• To analyze the impact of ESS on CRSwNP treatment.
• To identify predictors for revision surgery in CRSwNP patients.

Main Methods:

• Retrospective cross-sectional study.
• Analysis of 517 CRSwNP patients undergoing ESS between 2013 and 2021.
• Comparison of characteristics between patients requiring revision ESS and those who did not.

Main Results:

• 15.1% of patients underwent revision ESS.
• Factors associated with revision surgery included hyposmia/anosmia, asthma, NSAID-exacerbated respiratory disease, and bilateral polyposis.
• Higher initial peripheral eosinophilia and Lund-Mackay scores were observed in patients needing revision; Lund-Mackay score was the sole independent predictor.

Conclusions:

• Peripheral eosinophilia and Lund-Mackay score correlate with increased likelihood of requiring revision ESS.
• These factors can aid in predicting post-operative outcomes for CRSwNP.
• Early identification of high-risk patients may facilitate multidisciplinary management.