Endotype-related recurrence pattern of chronic rhinosinusitis in revision functional endoscopic sinus surgery

Seung No Hong, Young Seok Kim, Hyunkyung Cha, Jin A. Park, Joon Kon Kim, Heonjeong Oh, Minju Kim, Hyun Tae Ryu, Sang Duk Hong, Dae Woo Kim

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Objective: The recurrence of chronic rhinosinusitis (CRS) after functional endoscopic sinus surgery (FESS) is influenced by various factors, potentially including the endotype based on the molecular pathophysiology of CRS. This study investigated differences in the recurrence pattern of CRS by endotype after primary FESS. Methods: This retrospective study enrolled patients who had undergone revision FESS for recurrent CRS. Based on their clinical diagnosis, the patients were divided into two endotype groups: recurrent eosinophilic CRS (rECRS) and recurrent non-eosinophilic CRS (rNECRS). We compared and analyzed preoperative computed tomography (CT) findings, including typical anatomical findings of recurred CRS such as lateralized middle turbinate and retained uncinate process, the sinus where recurrence took place, and previous surgical completeness of the sinuses, between the rECRS and rNECRS groups. Results: In total, 142 patients were enrolled (48 rECRS, 94 rNECRS). No significant difference was found in the typical anatomic findings of recurrent CRS between the rECRS and rNECRS groups. The rates of the completeness of previous surgeries was significantly higher in rECRS than in rNECRS(P=.031). Despite the completeness of previous surgeries, the recurrence rate of frontal and ethmoidal sinuses was higher in the rECRS than rNECRS(P=.012, P<.001, respectively). In subgroup analysis according to the severity of ECRS, the number of involved sinuses and the rates of CRS recurrence and surgical completeness in frontal and anterior ethmoidal sinuses increased with ECRS severity. Conclusions: CT findings of revision FESS cases differed by CRS endotype. The rECRS group showed higher recurrence in the frontal and ethmoidal sinuses despite a higher surgical completeness rate. Incomplete surgery was more often found in the rNECRS group.

Original languageEnglish
Pages (from-to)215-221
Number of pages7
JournalAuris Nasus Larynx
Issue number2
StatePublished - Apr 2022


  • Chronic rhinosinusitis
  • Computed tomography
  • Disease recurrence
  • Endoscopic sinus surgery
  • Endotype
  • Paranasal sinus


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