Bariatric Surgery Reduces Risk of CRS and Sinus Surgeries by Up to 48% in Obese Patients: Study

Chronic rhinosinusitis, a persistent inflammatory condition of the sinuses, affects more than 10% of adults in the United States and significantly burdens the healthcare system. Its symptoms often overlap with other inflammatory conditions, such as asthma and allergic rhinitis, which are themselves strongly associated with obesity. With over 40% of the US population affected by obesity, understanding how weight-loss interventions influence inflammatory airway diseases has become increasingly important.

To investigate this, Shvetali Thatte and Mohamad R. Chaaban from Cleveland Clinic, Head and Neck Institute, Cleveland, Ohio, USA, conducted a large retrospective cohort study using data from the US Collaborative Network on the TriNetX Analytics Platform. The study included over 17 million adult patients with obesity, of whom 53,454 had undergone bariatric surgery. Patients in both the surgery and non-surgery groups were matched for demographics and common comorbidities, including tobacco use, asthma, and allergic rhinitis.

The following were the key findings of the study:

• Patients who underwent bariatric surgery had a 21% lower risk of developing chronic rhinosinusitis (CRS) within two years (RR 0.79).
• This reduced risk of CRS remained consistent at five years post-surgery (RR 0.79).
• At ten years following surgery, the risk of developing CRS further decreased (RR 0.73).
• Among patients with existing CRS, those who underwent bariatric surgery were 48% less likely to require functional endoscopic sinus surgery (FESS) at two years (RR 0.52).
• The reduced need for FESS continued at five years (RR 0.56).
• At ten years post-surgery, the likelihood of needing FESS further decreased (RR 0.50).

These findings suggest that bariatric surgery may offer a protective effect against CRS and its progression, likely due to the improvement in systemic inflammation associated with significant weight loss. Researchers also performed sub-analyses excluding patients prescribed GLP-1 receptor agonists—another class of weight-loss agents shown to affect respiratory health—to ensure the observed effects were attributable to bariatric surgery alone.

The authors conclude that in addition to metabolic and cardiovascular benefits, bariatric surgery may positively influence upper airway health. They advocate for further prospective studies to explore the biological mechanisms underlying these findings and to determine whether early surgical intervention could prevent the onset or progression of CRS in obese individuals.

As the obesity epidemic continues to grow, these findings underscore the potential for bariatric surgery to not only improve general health but also reduce the burden of chronic sinonasal disease and associated surgical interventions.

Reference:

Thatte, S., & Chaaban, M. R. Bariatric Surgery Lowers Incidence of Chronic Rhinosinusitis and Functional Endoscopic Sinus Surgery. The Laryngoscope. https://doi.org/10.1002/lary.32265