Early Endoscopic Sinus Surgery after Medical Failure Improves Postoperative Inflammation Control in Chronic Rhinosinusitis without Nasal Polyps
Usaporn Prapaisit¹, Virat Kirtsreesakul¹, Suchet Chinpairoj¹, Chakapan Promsopa¹
Affiliation : ¹ Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
Objective: To determine the association between time to elective endoscopic sinus surgery (ESS) and postoperative medication consumption and cost during a two-year follow up in patients with chronic rhinosinusitis without nasal polyps (CRSsNP).
Materials and Methods: The authors reviewed medical records of patients treated with ESS after medical failure between 2009 and 2020 at the Songklanagarind Hospital. The patients were divided into three groups, early surgery at less than one year, mid-surgery at one to five years, and late surgery at more than five years. The number of postoperative visits, CRS-related medications, and costs were compared among the groups. Multivariate analysis was performed to estimate the relationships between the independent factors.
Results: Sixty-nine patients were enrolled in the present study with 30.4% who underwent early surgery, 52.2% who were treated with mid-surgery, and 17.4% who underwent late surgery. The number of 2-year postoperative intranasal corticosteroids (INCS) used, and CRS-related medication costs compared with the time to surgery were significantly different. The higher frequency of prescriptions for INCS use and CRS-related medication costs were significantly different between the groups.
Conclusion: Time to sinus surgery was associated with the 2-year postoperative INCS use and CRS-related medication costs. Early surgery, after the appropriate medical treatment failed, was a better prognostic predictor for reduced INCS use and medication costs after surgery and could be an effective option for improving postoperative inflammation control and managing CRS.
Received 1 December 2023 | Revised 27 March 2024 | Accepted 29 March 2024
DOI: 10.35755/jmedassocthai.2024.5.13987
Keywords : Chronic sinusitis; Sinus surgery; Outcome; Time to surgery; Predictive factor
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