Azar A, et al. - This research was formulated in order to explore the gender variations in another cohort of adult patients with chronic rhinosinusitis (CRS) who underwent endoscopic sinus surgery (ESS). Authors also performed a comparison of the crucial histopathologic and serologic features. A higher Sino-Nasal Outcome Test (SNOT-22) symptom burden was reported among women who underwent ESS for CRS. Worsened symptomatology could be secondary to a higher prevalence of primary headache disorders in women. Nevertheless, surgeons were cautioned regarding female patients with CRS who sought ESS probably presenting with a higher prevalence of severe disease endotypes (more tissue fungal elements, elevated serum immunoglobulin E (IgE) levels) and phenotypes.

Methods

• An inspection was conducted of the patients with CRS who underwent ESS (from 2011 to 2014) with structured histopathology reports on surgical samples.
• The 13-item structured histopathology report detailed vital metrics of inflammation and the presence of fungal elements.
• Researchers compared the clinical, 22-item Sino-Nasal Outcome Test (SNOT-22) score, Lund-Mackay computed tomography (CT) score, serologic (immunoglobulin E [IgE] level, absolute eosinophil count) and histopathologic data between male and female patients with the aid of the statistical software.

Results

• A total of 130 candidates were eligible for this study (mean age, 54.7 years; 49.2% women).
• Women exhibited substantially higher preoperative SNOT-22 scores (women, 48.7; men 38.0 [p=0.004]) but similar CT scores than men.
• Prominently higher serum IgE levels were discovered among women vs men (peak, 433.3 vs 190.8 kU/L [p = 0.03]; closest to surgery, 435.0 vs 190.8 kU/L [p=0.03]).
• Tissue fungal elements appeared to be prominently more prevalent in women than men (19.0 vs 5.2%; p=0.02).
• The analysis was found to be agnostic of clinical details of the individuals, upto this point.
• Additional exploration was required with regard to the clinical features.
• In female patients, allergic fungal sinusitis (AFS) was considerably more common than male patients (21.9 vs 9.1%; p=0.04).
• Women exhibited higher prevalence of migraine (19.4 vs 4.6%; p=0.01) or any primary headache disorders (23.0 vs 6.2%; p=0.007) than men.