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Background Methods Results Conclusion Nasal discharge is one of the cardinal symptoms of chronic rhinosinusitis, impacting over 50% of patients. For patients with symptoms refractory to standard medical therapy, endoscopic sinus surgery is an option. The objective of this study is to characterize how nasal discharge improves after surgery in patients with chronic rhinosinusitis.The literature was searched for articles reporting nasal discharge symptom data both at baseline and after surgery. Specific symptoms of interest on the 22‐item sinonasal outcome test (SNOT‐22) were “need to blow nose,” “runny nose,” “postnasal discharge,” and “thick nasal discharge.” SNOT‐22 scores ranged from 0 to 5 based upon severity. Visual analog scale equivalents were recorded when available. A total of 16 studies (n = 7193) were included in the analysis. All four nasal discharge questions on the SNOT‐22 saw significant improvement, with need to blow nose (‒1.8 [95% confidence interval, CI: ‒2.3, ‒1.2]) and runny nose (‒1.8 [95% CI: ‒1.9, ‒1.1]) seeing the largest benefit. Patients with nasal polyps saw more improvement than those without polyps. The difference between polyp and no polyp groups was significant for need to blow nose (‒1.9 vs. ‒1.0, p < 0.001) and runny nose (‒1.8 vs. ‒1.0, p < 0.0001). Patients undergoing index or revision surgery all saw significant improvement in symptoms.Surgery for chronic rhinosinusitis improves nasal discharge globally, with particular benefit to need to blow nose and runny nose on the SNOT‐22. Patients with nasal polyps see larger degrees of improvement compared to those without polyps. However, patients without nasal polyps also experience significant improvement in discharge. [ABSTRACT FROM AUTHOR]

Objective: The modified frailty index (mFI‐5) is a National Surgical Quality Improvement Program‐derived 5‐factor index that has been proven to reflect frailty and predict morbidity and mortality. We hypothesize that mFI‐5 is a valid predictive measure in the transoral robotic surgery (TORS) population. Methods: Retrospective study utilizing the TriNetX US‐collaborative health records network querying for TORS patients. Cohorts were stratified by mFI‐5 score which uses five ICD‐10 codes: nonindependent functional status, hypertension, obstructive respiratory disease, heart failure, and diabetes mellitus. Cohorts were matched by age using propensity score matching. Outcome measures included survival, infection, pneumonia, tracheostomy dependence, and percutaneous endoscopic gastrostomy dependence. Reported odds ratios were normalized to mFI‐5 = 0. Results: A total of 9,081 patients were included in the final analysis. Greater mFI‐5 scores predicted decreased survival and increased incidence of postoperative infection and pneumonia. Odds of 5‐year mortality were 1.93 (p = 0.0003) for mFI‐5 = 2 and 1.90 (p = 0.0002) for mFI‐5 = 3. Odds of 2‐year mortality were 1.25 (p = 0.0125) for mFI‐5 = 1, 1.58 (p = 0.0002) for mFI‐5 = 2, and 1.87 (p = 0.003) for mFI‐5 = 3. Odds of postoperative infection were 1.51 (p = 0.02) for mFI‐5 = 2 and 1.78 (p = 0.05) for mFI‐5 = 3. Two‐year odds of developing pneumonia were 1.69 (p = 0.0001) for mFI‐5 = 2 and 2.84 (p < 0.0001) for mFI‐5 = 3. Two‐month odds of pneumonia were 1.50 (p = 0.0259) for mFI‐5 = 2 and 2.55 (p = 0.0037) for mFI‐5 = 3. mFI‐5 = 4 or 5 had too few patients to analyze. Using polynomial regression to model age versus incident 5‐year post‐TORS death (R2 = 0.99), mFI‐5 scores better predicted survival than age alone. Conclusion: This study demonstrates that mFI‐5 predicts mortality, pneumonia, and postoperative infection independently of age. Level of Evidence: 4 Laryngoscope, 134:4278–4283, 2024 [ABSTRACT FROM AUTHOR]