Outcomes of limited versus extensive surgery for chronic rhinosinusitis: A systematic review and meta‐analysis

Abstract

KEY POINTS There is no consensus on the extent of appropriate surgery for chronic rhinosinusitis (CRS), particularly CRS without polyps (CRSsNP). There is wide heterogeneity in the definition of “limited” and “extensive” endoscopic sinus surgery (ESS). Studies on the appropriate extent of surgery for CRS are needed.

Hyperuricemia Increases the Risk of Postoperative Recurrence in Chinese Patients with Chronic Rhinosinusitis

“…Currently, the treatment of CRS includes medical and surgical therapy, and functional endoscopic sinus surgery (FESS) is the mainstay for CRS patients who are refractory to medical management. 8 , 9 FESS can remove polyps and inflammatory tissues, open obstructed sinus to create larger ventilation space, reduce the antigenic load, and then facilitate the delivery of postoperative topical medications. 1 , 10 Although FESS can provide immediate and long-term symptom relief and improve the quality of life in most CRS patients, a certain proportion of them still suffer the risk of recurrence during the postoperative follow-up.…”

“…9 /L) 0.2 (0.1-0.3) 0.2 (0.1-0.3) 0.1 (0.1-0.3) Peripheral blood eosinophil percentage (%) 2.5 (1.1-4.9) 2.6 (1.1-5.4) 2.1 (1.0-4.4) Abbreviations: CRS, chronic rhinosinusitis; BMI, body mass index; VAS, visual analogue score; SBP, systolic blood pressure; DBP, diastolic blood pressure; FBG, fasting blood glucose; TG, triglyceride; TC, total cholesterol; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol. https://doi.org/10.2147/JIR.S457387 DovePress Journal of Inflammation Research 2024:17 2672 Abbreviations: CRS, chronic rhinosinusitis; CRSsNP, chronic rhinosinusitis without nasal polyps; CRSwNP, chronic rhinosinusitis with nasal polyps; BMI, body mass index; VAS, visual analogue score; SBP, systolic blood pressure; DBP, diastolic blood pressure; FBG, fasting blood glucose; TG, triglyceride; TC, total cholesterol; LDL-C, lowdensity lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol.…”

Abnormal S100A8 expression associates with postoperative recurrence in chronic rhinosinusitis with nasal polyps

“…Currently, CRS could be further classified into two phenotypes, CRS with nasal polyp (CRSwNP) and CRS without nasal polyp (CRSsNP), based on the presence or absence of polyps under nasal endoscopy [ 4 , 5 ]. In contrast to CRSsNP, CRSwNP is characterized by T helper 2 (Th2) type inflammation and eosinophil infiltration as the main pathological feature, and the degree of eosinophil infiltration in the polyp tissue was found to be associated with the poor treatment outcomes and increase the risk of recurrence after surgery [ [6] , [7] , [8] ].Therefore, exploring strategies to prevent the postoperative recurrence of CRSwNP and identifying objective biomarkers for predicting its recurrence is extremely crucial. Although previous studies mentioned that the nasal microbiome, serum metabolites, and sinus CT score could be used to assess postoperative recurrence, the use of these indicators was limited by their lack of objectivity in clinical applications [ [9] , [10] , [11] ].…”

Long-Term Clinical Outcomes in Patients with Chronic Rhinosinusitis with Nasal Polyps Associated with Expanded Types of Endoscopic Sinus Surgery

“…These approaches are driven by novel theories that integrate anatomical and inflammatory concepts (i.e., the mucosal concept), aimed at enhancing comprehension and management of the CRSwNP disease [18]. Although E-FESS has often been described as a complete sphenoethmoidal resection, associated with a maxillary antrostomy and a modification of the frontal sinus ostium [19][20][21], different surgical definitions, with no clear criteria by which to comprehensively define their appropriate extent, coexist in the literature, rendering an effective comparison of results among studies especially difficult [22,23].…”