Patients and Settings

The present retrospective study was approved by the Human Ethical Committee in Xiangya Hospital of Central South University (protocol no.202209212). This study complies with the Declaration of Helsinki. As this retrospective study did not involve any patient’s private information or commercial interests, it was deemed exempt from requiring informed consent by the Ethics Committee. The study design and participant selection are presented as a flow chart in Figure 1. CRS patients who underwent FESS at our medical center between January 2018 and December 2021 were enrolled in this study. All CRS patients met the diagnostic criteria provided by the European Position Paper on Rhinosinusitis and Nasal Polyps 2012 (EPOS 2012) and required FESS because of failed medical treatment.²⁶ Clinical diagnosis was made based on physical examination, clinical symptoms, nasal endoscopy findings, and sinus CT scan. We excluded the following patients: incomplete clinical data; accompanied with fungal sinusitis, allergic fungal rhinosinusitis, or sinonasal benign or malignant tumors; current acute inflammation; previous radiotherapy; aged < 18 years or >70 years.

Flowchart classification of the CRS cohort.

After FESS, all postoperative CRS patients were instructed to follow a treatment regimen that included daily nasal saline irrigation, antibiotics, topical corticosteroids, and periodic endoscopic debridement. Regular follow-up appointments were scheduled for patients, during which endoscopic examinations were performed to monitor their progress. Recurrence was defined by reappeared clinical symptoms, endoscopic signs, and/or CT evidence for at least 2 months despite the rescue regimen of antibiotics and oral steroids as previously described.^27,28 Based on a minimum follow-up period of 2 years, the patients were categorized into two groups: the recurrent group and the non-recurrent group.