Radiological score, asthma and NSAID-exacerbated respiratory disease predict relapsing chronic rhinosinusitis

Abstract

Objectives: The aim was to evaluate the predictive potential of Sinonasal Radiological (SR) and the Lund-Mackay (LM) score of sinus computed tomography (CT) scans on postoperative relapses of chronic rhinosinusitis (CRS). Materials and Methods: CRS patients (n = 483, 12–80 years) underwent routine sinus CT scans. The SR score was defined by obstructed frontal recess (0 = no, 1 = yes) and visualization of middle and inferior turbinate (0 = anatomy can be easily visualized, 1 = anatomy cannot be easily visualized) on each side (a total of 0–6 points). Associations were analyzed by nonparametric, survival and Cox's proportional hazard models. Results: Revision endoscopic sinus surgery (ESS) was performed in 133 (28.0%) patients on average (min–max) of 3.2 (0–12) years after performing the sinus CT scans. Of the 408 patients who underwent the baseline ESS, high preoperative SR or LM scores significantly predicted revision ESS (p < 0.001) and peroral corticosteroid courses purchased during the follow-up (p = 0.009 and p < 0.001, respectively for SR- and LM-scores). In multivariable analysis, both SR score and asthma and/or NSAID exacerbated respiratory disease (N-ERD) were significantly associated with revision ESS risk (p = 0.035, p = 0.007, respectively). Conclusion: LM and SR and a history of asthma or N-ERD predict CRS relapses, which may help in decision-making.