Usefulness of post-operative endoscopic score for optimal treatment selection in recurrent eosinophilic chronic rhinosinusitis

J Laryngol Otol. 2024 Feb;138(2):162-168. doi: 10.1017/S0022215123000798. Epub 2023 May 24.

Abstract

Objective: This study retrospectively analysed post-operative endoscopic scores to determine the optimal post-operative treatment in patients with eosinophilic chronic rhinosinusitis undergoing functional endoscopic sinus surgery.

Methods: In total, 339 adults who underwent initial bilateral functional endoscopic sinus surgery for eosinophilic chronic rhinosinusitis were enrolled. Patients were divided into group A, which required no additional post-operative treatment; group B, which required local/systemic steroids post-operatively; and group C, which further required dupilumab and/or revision surgery.

Results: Sixty-five per cent of patients could be treated with initial functional endoscopic sinus surgery (group A). Post-operative steroids were required in 35 per cent of patients with a post-operative endoscopic score of 30 per cent (group B). Further advanced treatments with dupilumab and/or revision functional endoscopic sinus surgery were required in 10 per cent of patients with a post-operative endoscopic score of 65 per cent (group C).

Conclusion: The post functional endoscopic sinus surgery endoscopic score can be used as an index to determine treatment at the time of eosinophilic chronic rhinosinusitis recurrence.

Keywords: Eosinophilia; operative procedures; recurrence; risk factors; steroids.

MeSH terms

  • Adult
  • Chronic Disease
  • Endoscopy / adverse effects
  • Humans
  • Nasal Polyps* / surgery
  • Retrospective Studies
  • Rhinitis* / etiology
  • Rhinitis* / surgery
  • Rhinosinusitis*
  • Sinusitis* / etiology
  • Sinusitis* / surgery
  • Steroids

Substances

  • Steroids