Preoperative Pollen Exposure and Chronic Rhinosinusitis Outcomes After Endoscopic Sinus Surgery: A Pilot Investigation

Background Although particulate matter is an environmental factor that may increase the risk of developing chronic rhinosinusitis (CRS), the impact of pollen on CRS outcomes is understudied. Here, we analyzed the effects of preoperative pollen exposure on disease‐specific and general quality‐of‐life (QOL) outcomes after endoscopic sinus surgery (ESS). Methods Prospectively enrolled patients with medically refractory CRS, who self‐selected ESS, completed the 22‐item SinoNasal Outcome Test (SNOT‐22) and Medical Outcomes Study Questionnaire Short‐Form 6‐D (SF‐6D) surveys at enrollment and follow up. Preoperative pollen counts were obtained from the National Allergy Bureau using residence zip codes and total pollen was divided into tree, ragweed, and grass/weed subcategories. Spearman's correlation coefficients ( r s ) and 95% confidence intervals (CI) were calculated and compared. Results Seventy‐nine patients met inclusion criteria with a mean follow‐up of 8 months. Higher average total pollen and tree pollen exposure 1 week before ESS were associated with less postoperative improvement in SNOT‐22 scores at follow up ( r s = −0.26; 95% CI: −0.46, −0.03; p = 0.021 and r s = −0.27; 95% CI: −0.47, −0.04; p = 0.017, respectively). Pollen exposure did not attenuate improvement of SF‐6D scores. Conclusion In this pilot investigation, increased preoperative pollen exposure attenuated improvement in SNOT‐22 scores after ESS.