Surgical Outcomes and Recurrence of Eosinophilic Chronic Rhinosinusitis

Abstract

　Eosinophilic chronic rhinosinusitis (ECRS) is an intractable disease, mainly characterized by nasal obstruction, nasal discharge, and olfactory dysfunction. Recurrence is common even after endoscopic sinus surgery (ESS). In the present study, the postoperative outcomes of 114 patients with ECRS who underwent their first surgery at our hospital after the Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis Study (JESREC study) established diagnostic criteria in 2015 were examined; the subjects were then classified into three groups according to the postoperative outcomes (good outcome, fair outcome, and recurrence), to examine the factors associated with recurrence. Subjective symptoms and changes in quality of life (QOL) among the three groups were also evaluated. Postoperative observation for one year or more (mean 38 months) showed that 40% had a good outcome, 27% had a fair outcome, and 32% experienced recurrence. Subjective symptoms and QOL improved significantly in all the groups as compared to the preoperative status of these parameters. However, only the rate of improvement of olfactory dysfunction was lower in the recurrence group as compared with that in the good outcome group. Even in the recurrence group, control with postoperative conservative treatment was achieved in those with low polyp scores. Reoperation and biological preparations were indicated for patients with high polyp scores and severe nasal obstruction and olfactory dysfunction, who accounted for less than 10% of all cases.