The Rate and Predictors of Allergic Fungal Rhinosinusitis Recurrence Post-sinus Surgery: A Retrospective Cohort Study

Area of Science:

• Otolaryngology
• Allergy Immunology
• Surgical Outcomes

Background:

• Chronic rhinosinusitis (CRS) is persistent sinus inflammation exceeding 12 weeks.
• Allergic fungal rhinosinusitis (AFRS) is a subtype with high recurrence rates, often requiring revision surgery.
• Identifying predictive factors for AFRS recurrence is crucial for improving patient management post-sinus surgery.

Purpose of the Study:

• To determine factors predicting the recurrence of allergic fungal rhinosinusitis (AFRS) in patients after undergoing sinus surgery.
• To analyze the association between comorbidities and surgical outcomes in AFRS patients.

Main Methods:

• A single-center retrospective study reviewed 116 patients with AFRS who had sinus surgery between 2000 and 2020.
• Data analysis focused on identifying correlations between patient characteristics, comorbidities, and post-operative recurrence.
• Statistical analysis included adjusted odds ratios (AOR) and confidence intervals (CI) to assess risk factors.

Main Results:

• 33.6% of patients experienced AFRS recurrence post-surgery, with most occurring within six months.
• Coexisting bronchial asthma (AOR, 3.43) and uncorrected deviated nasal septum (DNS) (AOR, 3.70) significantly increased recurrence likelihood.
• Concomitant sinus headaches were associated with a reduced likelihood of recurrence (AOR, 0.34).

Conclusions:

• AFRS recurrence affects over a third of patients post-surgery, highlighting the need for targeted management.
• Bronchial asthma and DNS are significant predictors of AFRS recurrence.
• While associated with recurrence, these factors do not automatically necessitate further surgical intervention.