Postoperative Outcomes of In-Office Endoscopic Sinonasal Procedures for Chronic Rhinosinusitis

BackgroundIn-office endoscopic sinonasal procedures under local anesthesia are gaining popularity for managing chronic rhinosinusitis (CRS), reducing wait times and costs. However, concerns remain regarding safety and efficacy.ObjectiveTo investigate the safety and efficacy of in-office endoscopic sinonasal procedures up to one year postoperatively.MethodsA retrospective review was conducted of adult patients (≥18 years) with CRS who underwent an in-office endoscopic sinonasal procedure under local anesthesia between January 2020 and December 2023. Patients were excluded if they were diagnosed with a sinonasal tumour. Safety was assessed using adverse events and complication rates, while efficacy was assessed with endoscopic visualization.ResultsA total of 165 patients were included. Intraoperative complications were rare, with two (1.2%) occurring in the CRS cohort. Four episodes of postoperative bleeding (2.5%) occurred, with two (1.3%) emergency department visits and one (0.6%) hospital admission. The median Modified Lund-Kennedy score (n=89) decreased from 4/12 to 3/12 at three (p = 0.0004) and six (p = 0.03) months postoperatively, and to 2/12 at twelve months postoperatively (p = 0.003).ConclusionIn-office endoscopic sinonasal procedures are a safe, effective, and well-tolerated treatment alternative for appropriate patients with CRS. This represents the largest Canadian study to date evaluating in-office endoscopic sinonasal procedures for CRS.