Changes in chronic rhinosinusitis: A retrospective analysis of computed tomography imaging and inflammatory changes either side of a 5‑year interval

Chronic rhinosinusitis (CRS) remains a prevalent and challenging condition characterized by variable clinical presentations and severity. The present study investigated changes in CRS characteristics either side of a 5-year interval to understand the impact of clinical advancements on disease management. A retrospective analysis was conducted on 120 patients diagnosed with CRS in 2017 and 2023 at The Second Hospital of Shanxi Medical University (Taiyuan, Chian). Standardized computed tomography imaging was performed, and sinonasal inflammation severity was evaluated using Lund-Mackay (LM) scores. Comparative analyses focused on anatomical variations, mucosal and submucosal features, and patterns of inflammation. Significant reductions in LM scores were observed in 2023 compared with those in 2017, indicating decreased sinonasal inflammation severity. Improvements were most pronounced in the osteomeatal complex (OMC) and frontal sinuses, with asymmetrical changes between the left and right sides. The left OMC and frontal sinus exhibited greater reductions in inflammation, whereas the right side showed less pronounced improvements. Analysis of mucosal thickening revealed a shift from diffuse to localized patterns, with reduced submucosal remodeling and fewer signs of chronic osteitis observed in 2023 compared with that in 2017. Anatomical variations, such as middle turbinate pneumatization and nasal septum deviation, remained unchanged between the two cohorts. This stability suggests that the observed reduction in disease severity may be more likely related to external factors such as earlier detection or evolving clinical practice, rather than anatomical differences. In conclusion, over the past 5 years, a marked reduction in CRS severity has been observed, particularly in regions critical for sinus ventilation and drainage. These findings may reflect broader changes in clinical practice over time, such as increased disease awareness, improved access to diagnostic tools or shifts in general management approaches, although specific treatment strategies or time of presentation were not directly assessed. The results also highlighting persistent asymmetry and inter-sinus variability. Further prospective studies integrating advanced imaging and molecular techniques are needed to improve understanding of these time trends and refine diagnostic and therapeutic approaches in CRS care.