OBJECTIVES

Functional endoscopic sinus surgery (FESS) has been shown to be effective in improving health-related quality of life (HRQoL) in patients with chronic rhinosinusitis with nasal polyps (CRSwNP), though patient selection remains crucial for optimising outcomes. This study aimed to identify predictors of improved postoperative HRQoL and predictors of revision surgery in CRSwNP patients undergoing FESS.

DESIGN

Cohort study.

SETTING

Tertiary referral hospital.

PARTICIPANTS

A total of 153 patients were enrolled in this study. They were asked to fill out the Endonasal Endoscopic Sinus and Skull Base Surgery Questionnaire (EES-Q) preoperatively, and then at 2 weeks, 3 months and 1 year postoperatively.

MAIN OUTCOME MEASURES

Linear mixed model (LMM) analyses were performed to evaluate the overall postoperative HRQoL and the separate health domains, as well as the impact of specific variables (sex, age, ASA classification, smoking, asthma, aspirin-exacerbated respiratory disease, allergic rhinitis, Lund-Mackay score, surgical procedure, postoperative antibiotics, postoperative prednisolone, FESS history, eosinophilia and preoperative EES-Q score) on HRQoL improvement. Using the same variables, a logistic regression analysis was performed to identify predictors of revision surgery.

RESULTS

The total EES-Q score (p < 0.001), as well as the physical (p < 0.001) and social (p < 0.001) domains, significantly improved postoperatively. In the LMM analysis, the preoperative EES-Q score was the only significant variable on the postoperative HRQoL outcome (p < 0.001). Eosinophilia was the only significant variable on revision surgery (p = 0.036).

CONCLUSIONS

FESS significantly improved postoperative HRQoL. Patients reporting worse preoperative HRQoL showed the greatest improvement postoperatively. Proven eosinophilia was the only significant predictor of revision surgery.