Guilherme Constante Preis Sella1, Edwin Tamashiro1, Juliana Augusta Sella2, Davi C Aragon3, Thais Nociti de Mendonça2, Luisa Karla de Paula Arruda2, Wilma Terezinha Anselmo Lima1, Fabiana Cardoso Pereira Valera4. 1. Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil. 2. Department of Allergology and Immunology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil. 3. Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil. 4. Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil. Electronic address: facpvalera@fmrp.usp.br.
Abstract
BACKGROUND: Factors associated with recurrence of chronic rhinosinusitis (CRS) are still poorly recognized. OBJECTIVE: To evaluate which risk factors could influence the risk of recurrence among patients undergoing endoscopic sinus surgery in long-term follow-up. METHODS: Patients with CRS who underwent endoscopic sinus surgery were followed for an average period of 12 years in a nonconcurrent cohort. After surgery, patients were considered to an additional endoscopic sinus surgery if appropriate medical therapy failed during this period. The presence of nasal polyps, asthma, nonsteroidal anti-inflammatory drug-exacerbated respiratory disease, smoking habits, peripheral blood eosinophilia, and atopy were assessed. The recurrence-free interval between groups (with or without these risk factors) was analyzed by Kaplan-Meyer curves, and the indication for a revisional surgery was considered to be the unfavorable event. RESULTS: A total of 201 patients were enrolled in this study. Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) were more likely than patients with chronic rhinosinusitis without nasal polyps (CRSsNP) to need revisional surgery (adjusted hazard ratio, 2.02). Asthma was the only factor that was significantly related to recurrence both in patients with CRSsNP (hazard ratio, 5.54) and in patients with CRSwNP (hazard ratio, 3.27). Although eosinophilia itself was not related to a higher chance of recurrence, its presence influenced the outcome of CRSwNP compared with CRSsNP and the impact of asthma among patients with CRSwNP. CONCLUSIONS: Prognosis in patients with CRSwNP was inferior to that in patients with CRSsNP. Asthma was the only factor that increased the chance of recurrence in patients with either CRSsNP or CRSwNP.
BACKGROUND: Factors associated with recurrence of chronic rhinosinusitis (CRS) are still poorly recognized. OBJECTIVE: To evaluate which risk factors could influence the risk of recurrence among patients undergoing endoscopic sinus surgery in long-term follow-up. METHODS:Patients with CRS who underwent endoscopic sinus surgery were followed for an average period of 12 years in a nonconcurrent cohort. After surgery, patients were considered to an additional endoscopic sinus surgery if appropriate medical therapy failed during this period. The presence of nasal polyps, asthma, nonsteroidal anti-inflammatory drug-exacerbated respiratory disease, smoking habits, peripheral blood eosinophilia, and atopy were assessed. The recurrence-free interval between groups (with or without these risk factors) was analyzed by Kaplan-Meyer curves, and the indication for a revisional surgery was considered to be the unfavorable event. RESULTS: A total of 201 patients were enrolled in this study. Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) were more likely than patients with chronic rhinosinusitis without nasal polyps (CRSsNP) to need revisional surgery (adjusted hazard ratio, 2.02). Asthma was the only factor that was significantly related to recurrence both in patients with CRSsNP (hazard ratio, 5.54) and in patients with CRSwNP (hazard ratio, 3.27). Although eosinophilia itself was not related to a higher chance of recurrence, its presence influenced the outcome of CRSwNP compared with CRSsNP and the impact of asthma among patients with CRSwNP. CONCLUSIONS: Prognosis in patients with CRSwNP was inferior to that in patients with CRSsNP. Asthma was the only factor that increased the chance of recurrence in patients with either CRSsNP or CRSwNP.
Authors: Karina Bayer; Selmir Hamidovic; Faris F Brkic; Gerold Besser; Christian A Mueller; David T Liu Journal: Eur Arch Otorhinolaryngol Date: 2022-06-23 Impact factor: 2.503
Authors: Junqin Bai; Julia H Huang; Caroline P E Price; Jacob M Schauer; Lydia A Suh; Regan Harmon; David B Conley; Kevin C Welch; Robert C Kern; Stephanie Shintani-Smith; Anju T Peters; Whitney W Stevens; Atsushi Kato; Robert P Schleimer; Bruce K Tan Journal: J Allergy Clin Immunol Date: 2022-03-16 Impact factor: 14.290