Pacientes con rinosinusitis crónica manejados mediante cirugía endoscópica nasal: análisis del sexo biológico como un determinante en su evolución clínica

Resumen

Introduction: Chronic rhinosinusitis (CRS) is a common disease. Nasal polyposis, asth­ma, age and sex are considered to be a risk factor for this patology. Objectives: To analyze biological sex as a clinical evolution determinant in chronic rhinosinusitis (CRS) patients electing functional endoscopic sinus surgery (FESS). Methods: Observational, retrospec­tive and analytical study. Adult patients with CRS undergoing FESS at Hospital del Sal­vador were included, from September 2021 to August 2023. Sociodemographic, imaging (Lund-Mackay classification), endoscopic (Lund-Kennedy classification) and quality of life Sino-Nasal Outcome Test (SNOT-22) pre and postoperative data were tabulated. Results: 55 patients were included (average age 51.8 years, 45% men). A 78% had CRS with nasal polyps (CRSwNP), with a similar distribution for both sexes. The preoperative Lund-Mackay averaged 15.87 (± 4.84 SD); being significantly higher in women (17.17 ± 4.12 SD versus 14.32 ± 5.26 SD; p = 0.029). Lund-Kennedy and SNOT-22 did not show significant differences for both sexes in the preoperative, or after 6 or 12 months postopera­tively. Conclusion: Men and women with CRS showed similar symptomatic burden in the preoperative period. However, in women with CRSwNP more severe symptoms was obser­ved. The women imaging findings in the preoperative were worse than in men. Women and men experienced a similar degree of symptomatic and endoscopic improvement up to 1 year postoperatively. Further studies are needed to understand the role of biological sex in the pathogenesis and prognosis of CRS.