{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T04:18:16Z","timestamp":1774153096499,"version":"3.50.1"},"reference-count":39,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:00:00Z","timestamp":1760400000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess whether patients of advanced age\u00a0with chronic rhinosinusitis (CRS) experience comparable symptom improvement and disease control following endoscopic sinus surgery (ESS) compared to younger patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>Systematic searches were performed across PubMed, Embase, Web of Science, Scopus, and CENTRAL to May 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Review Methods<\/jats:title>\n                    <jats:p>Following PRISMA guidelines, we included comparative studies with age\u2010stratified cohorts reporting outcomes for CRS patients undergoing ESS. The primary outcome was symptom improvement measured by the 22\u2010item Sinonasal Outcome Test (SNOT\u201022). Secondary outcomes were disease recurrence and revision rates. Meta\u2010regression examined the influence of sex, preoperative symptom severity, nasal polyps, and prior ESS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Across the included studies, data from 3161 patients were analyzed. Advanced\u2010age patients demonstrated significantly less SNOT\u201022 improvement than younger counterparts (SMD\u2009\u22120.36; 95% confidence interval [CI], \u22120.61 to \u22120.10;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.01). Nevertheless, recurrence and revision rates were lower in the advanced\u2010age group\u201412% and 3%, respectively\u2014corresponding to a 50% reduction in combined risk (RR 0.50; 95% CI, 0.33\u20100.75;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Meta\u2010regression identified male sex as a predictor of greater symptom improvement in advanced\u2010age patients (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20090.06,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.03), whereas prior ESS was associated with diminished improvement (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22120.05,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients of advanced age may experience less pronounced symptomatic improvement but lower recurrence and revision rates after ESS. These differences should be interpreted with caution, as they may reflect both surgical outcomes and other factors such as comorbidities or reoperation thresholds. Age alone should not preclude ESS, which remains an effective option when tailored to individual patient characteristics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70043","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T12:55:45Z","timestamp":1760446545000},"page":"1348-1358","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Advanced Age in Sinus Surgery: Diminished Symptom Gains but Enhanced Surgical Durability in Chronic Rhinosinusitis"],"prefix":"10.1002","volume":"173","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6035-9566","authenticated-orcid":false,"given":"Ahmad A.","family":"Mirza","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Faculty of Medicine in Rabigh King Abdulaziz University Jeddah Kingdom of Saudi Arabia"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Temerty Faculty of Medicine University of Toronto Toronto Ontario Canada"},{"name":"Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hussam A.","family":"Senan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery King Faisal Hospital Makkah Kingdom of Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan C.","family":"Hernaiz\u2010Leonardo","sequence":"additional","affiliation":[{"name":"Department of Surgery Faculty of Medicine, Divison of Otolaryngology\u2014Head and Neck Surgery University of British Columbia Vancouver British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6733-0640","authenticated-orcid":false,"given":"Osama A.","family":"Marglani","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Otolaryngology, Head and Neck Surgery, Faculty of Medicine Umm Al\u2010Qura University Makkah Kingdom of Saudi Arabia"},{"name":"Department of Surgery King Faisal Specialist Hospital &amp; Research Center Jeddah Kingdom of Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8473-4674","authenticated-orcid":false,"given":"John M.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Division of Rhinology, St. Michael's Hospital Unity Health Toronto Toronto Ontario Canada"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Division of Rhinology University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad R.","family":"Sedaghat","sequence":"additional","affiliation":[{"name":"Department of 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