Xiaoying Zhou,1,* Dan Wang,2,* Shouming Cao,1 Yi Tu,1 Rui Chen,1 Haosu Huang,1 Wenrong Lou3 

1Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China; 2Department of Algology, The Second Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China; 3Department of Otolaryngology-Head and Neck Surgery, The Affiliated Yan’an Hospital of Kunming Medical University, Kunming, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Wenrong Lou, Department of Otolaryngology-Head and Neck Surgery, The Affiliated Yan’an Hospital of Kunming Medical University, Kunming, 650051, People’s Republic of China, Email louwenrong@kmmu.edu.cn

Objective: Rheumatoid arthritis (RA) may share pathophysiological mechanisms with chronic rhinosinusitis (CRS), but its impact on CRS remains unclear. This study aimed to investigate the associations between RA and CRS disease severity, as well as postoperative recurrence risk.
Methods: A retrospective analysis was conducted on CRS patients who underwent functional endoscopic sinus surgery. Patients were divided into subgroups based on the presence of RA and gender. CRS patients were followed up for three years and categorized into non-recurrent and recurrent groups. Binary logistic regression analyses were performed to investigate the impact of RA on the risk of postoperative recurrence in CRS.
Results: Among 568 CRS patients, 169 experienced recurrence after three years. The RA group showed a significantly higher recurrence rate than the non-RA group in both genders (P < 0.05). In addition, RA patients had younger age, higher body mass index, higher prevalence of nasal polyps, and higher baseline VAS, Lund-Kennedy, and Lund-Mackay scores. At three-year follow-up, the RA group demonstrated greater improvements in VAS and Lund-Kennedy scores (P < 0.05). Logistic regression identified RA, allergic rhinitis, and asthma as independent risk factors for CRS recurrence (P < 0.05). Unadjusted and adjusted analysis highlighted RA as an independent predictor in males and females. Kaplan-Meier analysis further revealed that RA was associated with a significantly higher risk of postoperative CRS recurrence (P < 0.05).
Conclusion: RA might aggravate the disease severity and affect the prognosis of CRS. Additionally, RA may be a potential risk factor for postoperative recurrence of CRS, regardless of gender.

Keywords: chronic rhinosinusitis, functional endoscopic sinus surgery, recurrence, rheumatoid arthritis