Radiological score, asthma and NSAID-exacerbated respiratory disease predict relapsing chronic rhinosinusitis

Area of Science:

• Otolaryngology
• Radiology
• Medical Imaging

Background:

• Chronic rhinosinusitis (CRS) is a prevalent condition requiring effective management strategies.
• Assessing the risk of postoperative relapses is crucial for patient outcomes and healthcare resource allocation.

Purpose of the Study:

• To evaluate the predictive value of Sinonasal Radiological (SR) and Lund-Mackay (LM) scores derived from sinus computed tomography (CT) scans for predicting postoperative relapses in CRS patients.
• To identify imaging biomarkers that can assist in clinical decision-making for CRS management.

Main Methods:

• A cohort of 483 CRS patients (aged 12-80 years) underwent routine sinus CT scans.
• The SR score was developed based on frontal recess obstruction and turbinate visualization (0-6 points).
• Statistical analyses included nonparametric, survival, and Cox's proportional hazard models to assess associations.

Main Results:

• High preoperative SR or LM scores significantly predicted the need for revision endoscopic sinus surgery (ESS) and courses of oral corticosteroids.
• In multivariable analysis, both the SR score and a history of asthma or NSAID-Exacerbated Respiratory Disease (N-ERD) were significantly associated with an increased risk of revision ESS.
• Revision ESS was performed in 28.0% of patients within an average of 3.2 years post-CT scan.

Conclusions:

• The Lund-Mackay (LM) and Sinonasal Radiological (SR) scores are valuable predictors of chronic rhinosinusitis (CRS) relapses.
• A history of asthma or NSAID-Exacerbated Respiratory Disease (N-ERD) further enhances the prediction of CRS recurrence.
• These imaging and clinical factors can aid clinicians in making informed decisions regarding CRS treatment and follow-up.