{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:49:28Z","timestamp":1786124968028,"version":"build-2736575974"},"reference-count":36,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["T32GM007753"],"award-info":[{"award-number":["T32GM007753"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["T32GM144273"],"award-info":[{"award-number":["T32GM144273"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Whether body mass index (BMI) influences long\u2010term clinical outcomes after endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS) remains unclear. We investigated whether BMI is associated with baseline symptom severity, longitudinal postoperative symptom trajectories, and time to revision surgery or biologic use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a longitudinal cohort study of adult CRS patients undergoing ESS at a tertiary care center with 5\u2010year follow\u2010up. Preoperative BMI was categorized as normal weight (&lt;\u200925.0\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ), overweight (25.0\u201329.9), and obese (\u2265\u200930.0). Outcomes were baseline 22\u2010item Sinonasal Outcome Test (SNOT\u201022) scores, longitudinal SNOT\u201022 trajectories analyzed via multivariable linear mixed\u2010effects models, and time to revision surgery or biologic use via multivariable Cox regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 664 patients, 35.4% were normal weight, 35.5% overweight, and 29.1% obese. Obese patients had significantly higher baseline SNOT\u201022 scores (\u03b2, 6.70; 95% CI, 2.56\u201310.85). A significant BMI\u2010by\u2010time interaction (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.033) revealed that obese patients' symptoms worsened at a greater rate over time, increasing by 0.82 points per year versus normal\u2010weight patients. Elevated BMI predicted higher revision surgery risk (hazard ratio [HR], 2.41; 95% CI, 1.11\u20135.22), particularly in patients with nasal polyps (HR, 5.30; 95% CI, 1.45\u201319.35). Preoperative BMI was not associated with subsequent biologic use (HR, 1.67; 95% CI, 0.64\u20134.36).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Elevated BMI was associated with worse baseline symptoms, progressive postoperative symptom deterioration, and increased revision risk. Although baseline SNOT\u201022 differences were below the minimal clinically important difference (MCID), cumulative longitudinal divergence exceeded the MCID by year 3, indicating that BMI should inform preoperative counseling and postoperative monitoring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>3.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70788","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T01:06:32Z","timestamp":1785805592000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Body Mass Index on Long\u2010Term Outcomes After Endoscopic Sinus Surgery"],"prefix":"10.1002","author":[{"given":"Jack Y.","family":"Ghannam","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Mass Eye and Ear, Mass General Brigham  Boston Massachusetts USA"},{"name":"Harvard\/MIT MD\u2010PhD Program, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allen S.","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Mass Eye and Ear, Mass General Brigham  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey T.","family":"Gray","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Mass Eye and Ear, Mass General Brigham  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer J.","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Mass Eye and Ear, Mass General Brigham  Boston Massachusetts USA"},{"name":"Department of Surgery Mass General Brigham  Boston Massachusetts USA"},{"name":"Center for Surgery and Public Health (CSPH), Department of Surgery Mass General Brigham  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph","family":"Metson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Mass Eye and Ear, Mass General Brigham  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"1","article-title":"Prevalence of Obesity and Severe Obesity Among Adults: United States, 2017\u20102018","volume":"360","author":"Hales C. 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