(1229) Evaluating Deviated Nasal Septum Contribution to Chronic Rhinosinusitis and Endoscopic Sinus Surgery Outcomes

Introduction: Chronic rhinosinusitis (CRS) is influenced by multiple predisposing risk factors, but the role of deviated nasal septum (DNS) remains unclear. This study evaluates whether DNS increases CRS incidence and the likelihood of undergoing functional endoscopic sinus surgery (FESS) in high-risk patient populations.

Methods: A retrospective analysis was conducted using the TriNetX database. Patients were categorized into cohorts for 9 known risk factors of CRS. Propensity matching was used to control for age, sex, race, and major comorbidities. For Analysis 1, patients with each risk factor were compared to those with the same risk factor and DNS, and the outcome of CRS was assessed. For Analysis 2, patients with CRS and the same risk factors were identified; those with and without DNS were compared, and the outcome of undergoing FESS was assessed.

Results: In Analysis 1, the presence of DNS increased the likelihood of CRS across all risk factor groups. For example, among patients with cystic fibrosis (CF), having DNS is associated with a 46.74% higher absolute risk of CRS (p < 0.001). In Analysis 2, DNS was associated with higher FESS rates across all risk factor groups. For example, having DNS was associated with a 8.12% absolute probability of undergoing FESS with CRS and severe combined immunodeficiency (SCID).

Conclusions: DNS significantly increases the risk of developing CRS in patients with predisposing high-risk conditions. DNS also increases the likelihood of undergoing FESS in patients with both CRS and these predisposing conditions. These findings highlight the importance of assessing for DNS in at risk patient populations and support consideration of early correction.