Role of Functional Endoscopic Sinus Surgery in Patients with Chronic Rhinosinusitis and Laryngopharyngeal Reflux: A Prospective Study.

Functional endoscopic sinus surgery (FESS) has long been established as an effective intervention for CRS, aimed at improving sinus ventilation and reducing inflammation. However, the utilization of FESS in the context of concurrent CRS and LPR is less well-defined, and the potential impact of sinus surgery on LPR symptoms remains an area of active investigation. This study was done to assess and compare the pattern of LPR symptoms in individuals with concurrent LPR and CRS before and after functional endoscopic sinus surgery (FESS) using the Reflux Symptom Index (RSI) and Reflux Finding Score (RFS). To evaluate the impact of FESS on the severity of CRS symptoms using the Sinonasal Outcome Test-22 (SNOT-22). To assess endoscopic changes in the nasal and paranasal sinuses post-FESS using the Lund-Kennedy Endoscopic Grading System. A prospective quasi-experimental study was performed on 30 patients diagnosed with concurrent chronic rhinosinusitis with laryngopharyngeal reflux. Patients were assessed for the symptoms of LPR using RSI and RFS. The severity of CRS was assessed using SNOT-22 and the Lund Kennedy Endoscopic grading system. All Patients underwent functional endoscopic sinus surgery performed by experienced otolaryngologists, and the scores were validated postoperatively at 1 week, 1 month and 3 months. The average preoperative RSI score of 24.87 ± 5.14 decreased to 19.63 ± 5.43 at 3 months post-surgery, reflecting a significant mean reduction of 5.23 (95% CI 5.70-0.23). The RFS score declined from 20.13 ± 5.16 before surgery to 17.10 ± 4.01 at 3 months post-surgery, with a mean difference of 0.93 (95% CI 0.08-1.78). SNOT-22 scores improved markedly from 60.10 ± 9.74 preoperatively to 28.13 ± 8.03 at 3 months post-operatively. While our study did not find a significant improvement in symptoms related to Laryngopharyngeal Reflux (LPR) following functional endoscopic sinus surgery (FESS), there are indications of potential benefits.