Abstract
Objective
To identify factors affecting the efficacy of steroid-eluting sinus stents implanted after endoscopic sinus surgery (ESS) in patients with chronic rhinosinusitis with nasal polyps (CRSwNP).
Methods
We performed a post-hoc analysis of a randomized self-controlled clinical trial on post-operative implantation of bioabsorbable steroid-eluting stents in patients with CRSwNP. Univariate logistic regression analysis was conducted to identify which of the following factors affect the response to post-operative stent implantation: sex, serum eosinophil levels, history of prior surgery, endoscopic scores, and comorbid conditions (asthma and allergic rhinitis). The primary outcome was the rate of post-operative intervention on day 30, and the secondary outcome was the rate of polypoid tissue formation (grades 2–3) on days 14, 30, and 90.
Results
A total of 151 patients with CRSwNP were included in the post-hoc analysis. Asthma was identified as the only risk factor for a poor response to steroid-eluting sinus stents on post-operative day 30, with an odds ratio of 23.71 (95% CI, 2.81, 200.16; P=0.004) for the need for post-operative intervention and 19 (95% CI, 2.20, 164.16; P=0.003) for moderate-to-severe polypoid tissue formation. In addition, the asthmatic group showed higher rates of post-operative intervention and polypoid tissue formation than the non-asthmatic group on post-operative day 30. Blood eosinophil levels were not identified as a risk factor for poor outcomes after stent implantation.
Conclusion
Comorbid asthma, but not blood eosinophil level, impairs the efficacy of steroid-eluting sinus stents in the short term after ESS in patients with CRSwNP.
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All authors declare no conflict of interest regarding the publication of this article.
Author Zheng LIU is a member of the Editorial Board for Current Medical Science. The paper was handled by other editors and has undergone rigorous peer review process. Author Zheng LIU was not involved in the journal’s review of, or decisions related to, this manuscript.
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This study was supported by grants from the National Natural Science Foundation of China (No. 81873694), the Key Research and Development Program of Hubei Province (No. 2021BCA119 and No. 2022BCA005), and Knowledge Innovation Program of Wuhan-Basic Research (No. 2022020801010446).
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Huang, A., Li, T., Li, Ms. et al. Association of Comorbid Asthma and the Efficacy of Bioabsorbable Steroid-eluting Sinus Stents Implanted After Endoscopic Sinus Surgery in Patients with Chronic Rhinosinusitis with Nasal Polyps. CURR MED SCI 43, 1005–1012 (2023). https://doi.org/10.1007/s11596-023-2786-6
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DOI: https://doi.org/10.1007/s11596-023-2786-6