Predictive Value of Preoperative Examinations for Early Prognosis After Functional Endoscopic Sinus Surgery in Chronic Rhinosinusitis With Nasal Polyps

Abstract

ABSTRACT Background Functional endoscopic sinus surgery (FESS) remains a primary treatment modality for chronic rhinosinusitis with nasal polyps (CRSwNP) refractory to medical management. This study aimed to evaluate the predictive value of routine preoperative examinations for early surgical outcomes following FESS in patients with CRSwNP. Methods This prospective cohort study evaluated whether routine preoperative assessments predict early outcomes after FESS in 181 patients with bilateral CRSwNP. Preoperative evaluations included Lund–Mackay CT scores, Lund–Kennedy endoscopy scores, symptom Visual Analogue Scale (VAS), SNOT‐22 and peripheral blood eosinophil counts. Patients were followed postoperatively at 2 weeks, 1, 3 and 6 months. Results Preoperative VAS showed the strongest correlation with 2‐week symptom improvement ( r = 0.633), remaining an independent predictor in multivariate analysis ( β = 0.58). Preoperative SNOT‐22 also independently predicted 2‐week outcomes ( β = 0.15). At 3 months, blood eosinophil counts predicted endoscopic improvement ( r = 0.305), while preoperative Lund–Kennedy scores strongly predicted 6‐month endoscopic outcomes ( r = 0.508). Conclusions Routine preoperative assessments provide valuable predictive information for early postoperative outcomes following FESS in CRSwNP. We expect these findings to support the integration of multimodal preoperative assessment to guide patient counselling and postoperative management expectations.