{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T12:14:34Z","timestamp":1764159274537,"version":"3.46.0"},"reference-count":28,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T00:00:00Z","timestamp":1764115200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Military Institute of Medicine in Warsaw","award":["522\/WIM"],"award-info":[{"award-number":["522\/WIM"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Chronic rhinosinusitis (CRS) with frontal sinus outflow tract (FSOT) obstruction frequently requires frontal beak reduction during endoscopic sinus surgery (ESS). While technical approaches such as rotary drilling or piezoelectric osteotomy may differ in precision and tissue preservation, it is unclear whether surgical instrument choice or patient-specific clinical characteristics influence postoperative quality of life (QoL). Methods: In this prospective cohort study, 49 adult CRS patients undergoing ESS with frontal beak reduction were enrolled (28 males, mean age 50 \u00b1 15 years). Osteotomy was performed using either a conventional drill (n = 25) or piezoelectric knife (n = 24). Baseline clinical data included presence of nasal polyps, asthma, and radiologic severity (Lund\u2013Mackay and Zinreich CT scores). Outcomes included patient-reported symptoms with the 22-item Sino-Nasal Outcome Test (SNOT-22) and visual analogue scale (VAS), and endoscopic Lund\u2013Kennedy scores, recorded preoperatively and at 1, 4, and 24 weeks postoperatively. Results: Both groups demonstrated significant postoperative improvement in SNOT-22 and VAS scores. No significant correlation was observed between SNOT-22 changes and Lund\u2013Kennedy scores in either tool group. Presence of nasal polyps was associated with higher pre- and postoperative Zinreich and Lund\u2013Mackay scores (p &lt; 0.05). Asthma was linked to higher early postoperative symptom burden (nasal blockage, clear discharge; p &lt; 0.05). Tool choice did not significantly influence QoL recovery or modify the effect of clinical characteristics on outcomes. Conclusions: Postoperative QoL improvement was driven primarily by baseline disease phenotype\u2014particularly nasal polyposis and asthma\u2014while the choice of osteotomy instrument did not significantly influence recovery trajectories. The Zinreich score provided additional phenotypic stratification in CRS with FSOT obstruction.<\/jats:p>","DOI":"10.3390\/jcm14238377","type":"journal-article","created":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T11:43:22Z","timestamp":1764157402000},"page":"8377","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors Influencing Outcome After Frontal Beak Reduction\u2014Does the Surgical Tool Matter?"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4140-2906","authenticated-orcid":false,"given":"\u0141ukasz","family":"Skrzypiec","sequence":"first","affiliation":[{"name":"Department of Otolaryngology and Laryngological Oncology with Clinical Department of Cranio-Maxillofacial Surgery, Military Institute of Medicine\u2014National Research Institute, 128 Szaser\u00f3w Street, 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kornel","family":"Szczygielski","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Laryngological Oncology with Clinical Department of Cranio-Maxillofacial Surgery, Military Institute of Medicine\u2014National Research Institute, 128 Szaser\u00f3w Street, 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dariusz","family":"Jurkiewicz","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Laryngological Oncology with Clinical Department of Cranio-Maxillofacial Surgery, Military Institute of Medicine\u2014National Research Institute, 128 Szaser\u00f3w Street, 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3683-9508","authenticated-orcid":false,"given":"Marta Aleksandra","family":"Kwiatkowska","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Laryngological Oncology with Clinical Department of Cranio-Maxillofacial Surgery, Military Institute of Medicine\u2014National Research Institute, 128 Szaser\u00f3w Street, 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1434","DOI":"10.1016\/j.jaip.2022.03.002","article-title":"Chronic Rhinosinusitis with Nasal Polyps: Quality of Life in the Biologics Era","volume":"10","author":"Mullol","year":"2022","journal-title":"J. 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