Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery · 2026
Predictive Value of Preoperative Examinations for Early Prognosis After Functional Endoscopic Sinus Surgery in Chronic Rhinosinusitis With Nasal Polyps.
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Zheng Xinyi, Zhou Min, Qiu Huijun, Liang Guixian, Zhang He, Wang Ruizhi, Li Yiwen, Li Ruijie, Wu Shuo, Zhang Yana, Shi Zhaohui, Yang Qintai
Аннотация
BACKGROUND: Functional endoscopic sinus surgery (FESS) remains a primary treatment modality for chronic rhinosinusitis with nasal polyps (CRSwNP) refractory to medical management. This study aimed to evaluate the predictive value of routine preoperative examinations for early surgical outcomes following FESS in patients with CRSwNP.
METHODS: This prospective cohort study evaluated whether routine preoperative assessments predict early outcomes after FESS in 181 patients with bilateral CRSwNP. Preoperative evaluations included Lund-Mackay CT scores, Lund-Kennedy endoscopy scores, symptom Visual Analogue Scale (VAS), SNOT-22 and peripheral blood eosinophil counts. Patients were followed postoperatively at 2 weeks, 1, 3 and 6 months.
RESULTS: Preoperative VAS showed the strongest correlation with 2-week symptom improvement (r = 0.633), remaining an independent predictor in multivariate analysis (β = 0.58). Preoperative SNOT-22 also independently predicted 2-week outcomes (β = 0.15). At 3 months, blood eosinophil counts predicted endoscopic improvement (r = 0.305), while preoperative Lund-Kennedy scores strongly predicted 6-month endoscopic outcomes (r = 0.508).
CONCLUSIONS: Routine preoperative assessments provide valuable predictive information for early postoperative outcomes following FESS in CRSwNP. We expect these findings to support the integration of multimodal preoperative assessment to guide patient counselling and postoperative management expectations.
METHODS: This prospective cohort study evaluated whether routine preoperative assessments predict early outcomes after FESS in 181 patients with bilateral CRSwNP. Preoperative evaluations included Lund-Mackay CT scores, Lund-Kennedy endoscopy scores, symptom Visual Analogue Scale (VAS), SNOT-22 and peripheral blood eosinophil counts. Patients were followed postoperatively at 2 weeks, 1, 3 and 6 months.
RESULTS: Preoperative VAS showed the strongest correlation with 2-week symptom improvement (r = 0.633), remaining an independent predictor in multivariate analysis (β = 0.58). Preoperative SNOT-22 also independently predicted 2-week outcomes (β = 0.15). At 3 months, blood eosinophil counts predicted endoscopic improvement (r = 0.305), while preoperative Lund-Kennedy scores strongly predicted 6-month endoscopic outcomes (r = 0.508).
CONCLUSIONS: Routine preoperative assessments provide valuable predictive information for early postoperative outcomes following FESS in CRSwNP. We expect these findings to support the integration of multimodal preoperative assessment to guide patient counselling and postoperative management expectations.