Endoscopic sinus surgery for fungal ball rhinosinusitis in South China: Long-term results and analysis of prognostic factors

Conclusion: Endoscopic sinus surgery (ESS) treatment has achieved good long-term results in patients in South China with fungal ball rhinosinusitis. Gender (female), age (young), nasal polyps, allergy, high Lund-Mackay scores, prior sinus surgery and diabetes mellitus affect patients' outcomes. Objective: To evaluate objective testing and quality of life (QOL) outcomes of patients with fungal ball rhinosinusitis before and after ESS in South China and to determine preoperative factors that predict surgical outcomes. Methods: We retrospectively analyzed the outcomes for 330 patients with fungal ball rhinosinusitis after ESS. QOL was assessed using Sinonasal Outcome Test - 20 (SNOT-20), Short Form-36 (SF-36) questionnaires and visual analogue scale (VAS). Objective testing was evaluated by Lund-Kennedy endoscopic scoring system. Prognostic factors were determined based on the QOL scores and Lund-Kennedy scores after ESS using a multivariate linear regression. Results: ESS significantly improved the objective testing and QOL outcomes in patients with fungal ball rhinosinusitis (p < 0.05). Objective outcome: postoperative Lund-Kennedy scores were significantly worse in patients with nasal polyps, allergy and high Lund-Mackay scores (p < 0.05). QOL outcomes: postoperative SF-36 scores were adversely affected by gender (female), age (young), nasal polyps, allergy and prior sinus surgery (p < 0.05); postoperative VAS scores were adversely affected by gender (female), nasal polyps, allergy and diabetes mellitus (p < 0.05).