Cannabis Use and Risk of Chronic Rhinosinusitis and Sinus Surgery

Area of Science:

• Otolaryngology
• Pharmacology
• Epidemiology

Background:

• The association between cannabis use and respiratory conditions like asthma is documented, but its impact on chronic rhinosinusitis (CRS) remains less understood.
• Investigating the relationship between cannabis consumption and CRS is crucial for understanding its broader health implications.

Purpose of the Study:

• To explore the association between cannabis use and the incidence of new-onset chronic rhinosinusitis (CRS).
• To examine the relationship between cannabis use and the development of chronic rhinosinusitis with nasal polyps (CRSwNP).
• To assess the impact of cannabis use on rates of functional endoscopic sinus surgery (FESS) among patients with CRS.

Main Methods:

• A retrospective cohort study utilizing the TriNetX Analytics Research Network, analyzing electronic health records from January 2012 to December 2019.
• Adult patients (≥18 years) were stratified into cannabis user and non-user groups, with propensity score matching applied for comparative analysis.
• Primary outcomes included relative risks of new-onset CRS and CRSwNP diagnoses and FESS at 1, 2, and 5 years post-initial cannabis use diagnosis.

Main Results:

• Cannabis use was linked to a significantly reduced risk of unspecified CRS at 1, 2, and 5 years post-diagnosis (aRR ranging from 0.83 to 0.87).
• No significant difference in the risk of developing chronic rhinosinusitis with nasal polyps (CRSwNP) was observed between cannabis users and non-users.
• Among patients with pre-existing CRS, cannabis users exhibited a lower risk of undergoing functional endoscopic sinus surgery (FESS) at 1, 2, and 5 years (aRR ranging from 0.64 to 0.69).

Conclusions:

• Cannabis use is associated with a statistically significant decrease in the risk of new-onset CRS and the need for FESS.
• The findings suggest a potential protective role of cannabis in the context of CRS, warranting further investigation into the underlying mechanisms.
• Additional research is recommended to elucidate the causal relationship and biological pathways involved in the observed associations between cannabis use and CRS outcomes.