Sinus surgery beneficial for Immunodeficient Chronic Rhinosi
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Immunodeficiency is a risk factor for recalcitrant chronic rhinosinusitis (CRS). Endoscopic sinus surgery (ESS) is beneficial for patients with CRS and immunodeficiency, suggests a recent study by the journal International Forum of Allergy & Rhinology.

This review aims to evaluate the existing evidence on the treatment outcomes and their limitations in patients with CRS and immunodeficiency.

MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from inception to April 2019 for studies reporting measurable medical or surgical treatment outcomes for adult patients with CRS and underlying primary or secondary immunodeficiency.

Of the 2459 articles screened, 13 studies met the inclusion criteria.

--Antibiotic monotherapy was not linked with significant improvement in clinical, radiographic, or endoscopic outcomes.

--Immunoglobulin replacement therapy may potentially reduce the frequency of acute or chronic sinusitis in patients with primary immunodeficiency (PID) but may not improve their sinonasal symptoms.

--Outcomes from endoscopic sinus surgery (ESS) were reported in 8 studies, which found that surgery was linked with improvement in symptoms, disease-specific quality of life, endoscopy scores, and radiographic scores. The average reported ESS revision rate was 14%.

Conclusively, patients with CRS and immunodeficiency likely benefit from ESS based on the available evidence. Data supporting medical therapy in this targeted population is limited overall, but there may be a potential role for immunoglobulin therapy in patients with PID and CRS.