Nasal Nitric Oxide Change after Functional Endoscopic Sinus Surgery

Abstract

Objectives:

Evaluate the symptom scores and nasal nitric oxide (nNO) in patients with chronic rhinosinusitis (CRS) after functional endoscopic sinus surgery (FESS).

Methods:

Through a non-invasive method, we prospectively collected pre- and post-operative nNO 3 months after FESS. Basic demographic data of patients, underlying diseases, image / endoscopy scores, allergy tests, rhinometries, and pre- and post-operative symptom scores (SNOT-22 and RQLQ) were recorded and analyzed.

Results:

Twenty-eight patients completed post-operative evaluation, including 12 CRS without nasal polyps (CRSsNP) and 16 CRS with nasal polyps (CRSwNP). Pre-operative nNO had no difference between two groups in our patients (P = 0.187). Other demographic and pre-operative data had no difference between these two groups except Lund-Mackey CT score (P < 0.001) and Lund-Kennedy endoscopy score (P = 0.031). We found disease severity strongly correlated with nNO only in nonallergic patients (P = 0.006 and <0.001 for CT score and endoscopy score, respectively). However, subjective symptoms did not correlate well with nNO. As to post-op nNO, the significant elevation was only detected in the CRSwNP group (P = 0.005). Several factors were found to correlate with post-operative nNO change, but all in nonallergic patients, including the existence of nasal polyps, Lund-Mackey score, asthma, and pre-operative nNO level.

Conclusions:

Collection of nNO is a quick, non-invasive method for evaluating sinus status. We may expect the nNO change after FESS is performed, especially in nonallergic patients, as another reference for outcome prediction before sinus surgery scheduled.