ONLY one in four patients with chronic rhinosinusitis (CRS) maintain full clinical control more than 5 years after endoscopic endonasal surgery (EES), according to new long-term follow-up data using the updated European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) criteria.
This observational cohort study assessed 123 CRS patients who completed both the Endoscopic Endonasal Sinus and Skull Base Surgery Questionnaire (EES-Q) and EPOS-based evaluations. Based on EPOS criteria, 25.2% of patients were classified as having controlled disease, 26.8% as partly controlled, and 48.0% as uncontrolled.
Several comorbidities and clinical factors were significantly linked to poorer outcomes, including nonsteroidal anti-inflammatory drug–exacerbated respiratory disease, allergic rhinitis, asthma, smoking, revision surgery, and nasal polyps. These associations underline the complex interplay between CRS and other airway or systemic conditions, which may contribute to persistent or recurrent symptoms despite surgical intervention.
Analysis of EES-Q domains revealed that the physical health component had the greatest influence on disease control, followed by social and psychological domains. This finding supports the need for a multidimensional approach to postoperative management, where symptom control is not solely assessed by physical measures but also by the patient’s broader quality-of-life experience.
The results indicate that while EES can provide substantial benefits, long-term success is far from guaranteed for many patients. Understanding and addressing the factors associated with incomplete control will be essential for optimizing outcomes. These findings also reinforce the value of ongoing monitoring and patient-centered care strategies to manage the chronic nature of CRS.
Reference:
Joustra GE et al. Long-term clinical control in chronic rhinosinusitis: Outcomes more than five years after surgery. Eur Arch Otorhinolaryngol. 2025. doi:10.1007/s00405-025-09529-z.
