Endotype-related recurrence pattern of chronic rhinosinusitis in revision functional endoscopic sinus surgery |
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| Affiliation: | 1. Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Boramae Medical Center, Seoul, South Korea;2. Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea;1. Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Nara, Japan;2. Department of Otolaryngology-Head and Neck Surgery, Nippon Life Hospital, Osaka, Japan;3. Department of Otolaryngology, Takai Hospital, Nara, Japan;1. Department of Otolaryngology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osakasayama-shi, Osaka 589-8511, Japan;2. Department of Otolaryngology, Head and Neck Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo 105-8470, Japan;3. Department of Otolaryngology, Akasaka Toranomon Clinic, 1-8-1 Akasaka, Minato-ku, Tokyo, 107-0052, Japan;4. Department of Otorhinolaryngology and Department of Hearing Implant Sciences, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan;5. Department of Hearing Implant Sciences, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621 Japan;6. Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan;1. Digestive and Lifestyle Diseases, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan;2. Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan;1. Tokyo Voice Center,International University of Health and Welfare, Tokyo, Japan;2. Department of Otolaryngology-Head and Neck Surgery, Jichi Medical University, Tochigi, Japan;3. AKASAKA Voice Health Center, Tokyo, Japan;4. Voice and Dizziness Clinic Futakotamagawa Otolaryngology, Tokyo, Japan;1. Department of Plastic and Reconstructive Surgery, Graduate School of Medical Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan;2. Department of Neurosurgery, Graduate School of Medical Sciences, Tokyo Medical and Dental University, Tokyo, Japan;3. Department of Otolaryngology, Graduate School of Medical Sciences, Tokyo Medical and Dental University, Tokyo, Japan;4. Department of Head and Neck Surgery, Graduate School of Medical Sciences, Tokyo Medical and Dental University, Tokyo, Japan;5. Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan |
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| Abstract: | ObjectiveThe recurrence of chronic rhinosinusitis (CRS) after functional endoscopic sinus surgery (FESS) is influenced by various factors, potentially including the endotype based on the molecular pathophysiology of CRS. This study investigated differences in the recurrence pattern of CRS by endotype after primary FESS.MethodsThis retrospective study enrolled patients who had undergone revision FESS for recurrent CRS. Based on their clinical diagnosis, the patients were divided into two endotype groups: recurrent eosinophilic CRS (rECRS) and recurrent non-eosinophilic CRS (rNECRS). We compared and analyzed preoperative computed tomography (CT) findings, including typical anatomical findings of recurred CRS such as lateralized middle turbinate and retained uncinate process, the sinus where recurrence took place, and previous surgical completeness of the sinuses, between the rECRS and rNECRS groups.ResultsIn total, 142 patients were enrolled (48 rECRS, 94 rNECRS). No significant difference was found in the typical anatomic findings of recurrent CRS between the rECRS and rNECRS groups. The rates of the completeness of previous surgeries was significantly higher in rECRS than in rNECRS(P=.031). Despite the completeness of previous surgeries, the recurrence rate of frontal and ethmoidal sinuses was higher in the rECRS than rNECRS(P=.012, P<.001, respectively). In subgroup analysis according to the severity of ECRS, the number of involved sinuses and the rates of CRS recurrence and surgical completeness in frontal and anterior ethmoidal sinuses increased with ECRS severity.ConclusionsCT findings of revision FESS cases differed by CRS endotype. The rECRS group showed higher recurrence in the frontal and ethmoidal sinuses despite a higher surgical completeness rate. Incomplete surgery was more often found in the rNECRS group. |
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