New CT-Based Risk Score Predicts Sinus Surgery Outcomes in Chronic Rhinosinusitis Patients.

A new scoring system based on CT scans may help predict which chronic rhinosinusitis patients are more likely to require additional sinus surgery after their initial procedure, according to a Finnish multi-centre study published in Clinical and Translational Allergy.

Chronic rhinosinusitis, a persistent inflammation of the nasal and sinus cavities, causes symptoms such as nasal blockage, mucus build-up, and facial pressure. In more severe, polypoid forms, mucosal growths—called polyps—can obstruct airflow and sinus drainage. This condition is often seen in individuals with asthma or NSAID-exacerbated respiratory disease (N-ERD).

Treatment usually begins with nasal corticosteroids, with oral corticosteroids added for severe or polypoid cases. When medications fail, endoscopic sinus surgery is considered. Before surgery, patients typically undergo a CT scan to assess sinus anatomy and inflammation.

In the recent study, researchers developed the sinonasal radiological (SR) score to better predict the likelihood of revision surgery following initial endoscopic sinus surgery. Unlike the widely used Lund-Mackay (LM) score, which assesses inflammation and drainage obstruction in the maxillary sinuses, the SR score focuses on anatomical features—such as undetectable nasal turbinates and blocked frontal sinus drainage—commonly linked to disease recurrence.

“This allows for early prediction of disease progression and planning of further treatment,” said Professor Sanna Toppila-Salmi of the University of Eastern Finland.

The study included 483 patients diagnosed with chronic rhinosinusitis. Of those, 85 underwent sinus surgery within a year of their CT scan. During the follow-up period, 28% of these patients required revision surgery. The combination of SR and LM scores significantly improved prediction of surgical outcomes, regardless of the surgical technique used.

Comorbid conditions like asthma and N-ERD were also found to elevate the risk of needing additional procedures. In such cases, if conventional therapies fail, biologic medications may be considered after thorough risk evaluation.

This new scoring method may enhance personalized care by identifying high-risk patients early in the treatment process.

Source:https://www.sciencedaily.com/releases/2025/04/250403122940.html

This is non-financial/medical advice and made using AI so could be wrong.