Bariatric Surgery Lowers Incidence of Chronic Rhinosinusitis and Functional Endoscopic Sinus Surgery.

Abstract

This study evaluates if undergoing bariatric surgery for patients with obesity results in a decreased incidence of chronic rhinosinusitis (CRS) and fewer functional endoscopic sinus surgeries (FESS). A retrospective cohort analysis was conducted using the US Collaborative Network on the TriNetX Analytics Platform. Adult patients with obesity (most recent value of BMI ≥ 30 kg/m²) were included and separated into two cohorts: one that underwent bariatric surgery (n = 53,454) and another that did not (n = 17,006,670). Patients in the two cohorts were matched by age, gender, race, tobacco use, and asthma and allergic rhinitis comorbidities. Outcomes analyzed included the incidence of CRS and FESS, identified by ICD-10 and CPT codes, respectively, within 2, 5, and 10 years. Patients with outcomes prior to the follow-up window were excluded. Two years after surgery, patients with obesity who underwent bariatric surgery had a decreased risk of developing CRS, with a relative risk (RR) of 0.79 (95% CI: 0.70-0.88). The risk remained lower at 5- and 10-year post-surgery, with a RR of 0.79 (95% CI: 0.73-0.86) and 0.73 (CI: 0.68-0.79), respectively. For patients with obesity and CRS, undergoing bariatric surgery resulted in fewer FESS at 2, 5, and 10 years after surgery, with a RR of 0.52 (95% CI: 0.35-0.79), 0.56 (95% CI: 0.42-0.76), and 0.50 (95% CI: 0.38-0.67), respectively. In patients with obesity, bariatric surgery is associated with a decreased incidence of CRS and fewer FESS. Further studies are needed to confirm results and consider other comorbidities and medical interventions.