Asthma increases revision rates of endoscopic sinus surgery in chronic rhinosinusitis: Study

Chronic rhinosinusitis with asthma (CRS‐A) has a significant impact on patient morbidity and quality of life. Nevertheless, little is known about the natural history of endoscopic sinus surgery (ESS) in this cohort.

Therefore, Amarbir S. Gill and colleagues from the Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of Utah, Salt Lake City, UT conducted the present study to evaluate revision rates of ESS in CRS‐A and identify risk factors associated with increased likelihood for revision surgery compared to those with CRS without asthma (CRS‐alone).

The Utah Population Database was queried for patients age >18 years with CRS who underwent at least 1 ESS. Demographic information and history of ESS were collected and compared between CRS‐A and CRS‐alone using chi‐square tests for categorical variables and t tests for continuous variables. Risk factors for revision surgery were analyzed using Cox proportional hazard models.

The authors included a total of 33,090 patients (7693 CRS‐A and 25,397 CRS‐alone) were in the final analysis.

The following results were seen-

a. Mean follow up was 9.8 years in CRS‐A and 9.1 years in CRS‐alone (p< 0.001).

b. The revision rate among patients with CRS‐A (21.5%) was twice that of CRS‐alone (10.8%) (p< 0.001).

c. Among patients with CRS, a history of allergy (p< 0.001), asthma (p< 0.001), and nasal polyposis (p< 0.001) was independently associated with increased risk of revision ESS. d. Patients with CRS‐A and nasal polyposis were 6 times more likely to require revision surgery than those with CRS‐alone (p< 0.010).

Hence, the authors concluded that "the rate of revision ESS in CRS‐A was twice that of CRS‐alone; patients with CRS‐A and nasal polyposis were 6 times more likely to require revision than those with CRS‐alone."