National Institute on Deafness and Other Communication Disorders, Grant/Award Number: R01DC005805
International Forum of Allergy & Rhinology
Chronic rhinosinusitis, Sinus surgery outcome assessment (healthcare), Cytokine -- Biomarker
It is unclear if chronic rhinosinusitis (CRS) endotypes show differential response to endoscopic sinus surgery (ESS). We explored mucus inflammatory cytokine expression in a cohort with CRS and associations with both patient-reported and clinically measured postoperative outcome measures.
Patients with CRS were prospectively recruited between 2016-2021 into a multi-center observational study. Mucus was collected from the olfactory cleft preoperatively and evaluated for 26 biomarkers using cluster analysis. Patient reported outcome measures included the Sino-Nasal Outcome Test (SNOT-22) and Questionnaire of Olfactory Dysfunction (QOD). Additional clinical measures of disease severity included Threshold, Discrimination, and Identification (TDI) scores using Sniffin’ Stick testing and Lund-Kennedy endoscopic scores (LKES).
A total of 115 patients were clustered into type 2 inflammatory, non-type 2 inflammatory, non-inflammatory, and 2 indeterminate clusters based upon individual protein levels. Overall, the type 2 inflammatory cluster was found to report the highest mean improvement in both SNOT-22 (-28.3 [SD±16.2]) and TDI (6.5 [SD±7.9]) scores 6 months after ESS. However, all endotype clusters demonstrated improvement in all outcome measures after ESS on average, without statistically significant between-group differences in SNOT-22 (p = 0.738), QOD (p = 0.306), TDI (p = 0.358), or LKES (p = 0.514) measures.
All CRS endotype clusters respond favorably to surgery and show improvement in patient reported and objective outcome measures. Thus, ESS should be considered a more generalized CRS therapy, and benefits appear to not be limited to specific endotypes.
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Published as: Chapurin, N., Schlosser, R. J., Gutierrez, J., Mace, J. C., Smith, T. L., Bodner, T. E., ... & Soler, Z. M. (2023, August). All chronic rhinosinusitis endotype clusters demonstrate improvement in patient reported and clinical outcome measures after endoscopic sinus surgery. In International Forum of Allergy & Rhinology.