Dual Burden of CRS and DNS: Assessing the True Therapeutic Value of FESS

Abstract

Introduction: CRS (chronic rhinosinusitis) is a complication of DNS (deviated nasal septum) and is responsible for a significant disease burden worldwide, with a prevalence of 11%. Methods: A comparative study of a hundred cases in the Comilla Medical College hospital (https://www.cumc.edu.com) and Cumilla Medical Center PVT LTD (http://comillamedicalcentre.com), Bangladesh. Set one: 50 surgeries were functional endoscopic sinus surgery (FESS)+ submucosal resection of the deviated portion of the septum (SMR); two 50 FESS surgeries were conducted from 01 January 2016 to 31 December 2024. Results: Males suffer more than females (64%; 32: set one) and (52%; 26: set two); rural and poor people are more affected by the disease: 76%; 38 in set one and 70%; 35 in set two. Symptoms were nasal obstruction, discharge, and headache in most patients (56%; 28: set one) and (40%; 20: set two). Follow-up schedule only one time 42; 84% in set one, but multiple in set two was 80% (40), revision surgery in set one 3;6%, and set two 35;70%. The mean age and follow-up duration in months were 40.86±5.099 years and 14.54±18.829 in set one, and 38.70±8.094 years and 65.38±28.749 in set two. The mean score of the Visual Analog Scale (VAS) before and after surgery in set one was 6.76 and .18, and set two was 6.66 and 6.60. Paired-sample t test showed significance in set one (p < .001) and non-significance in set two (p = .083). Univariate evaluation of factors showed sex, follow-up category, sex*follow-up category, age*follow-up category, SES, and SES*follow-up category were significant in set one. Still, except for the follow-up category, all were insignificant in set two. Conclusion: Our comparison showed that CRS with DNS patients’ needs doubles the number of surgeries required at a time, consequently reducing the patient burden.