Personalizing sinus surgery: a systematic review and meta-analysis of clinical and genetic predictors of outcome in chronic rhinosinusitis

, publication bias using funnel plots and Egger test, and evidentiary certainty using GRADE. A total of 17 trials with 40,059 individuals were examined. Asthma, non-steroidal anti-inflammatory drug (NSAID) intolerance, allergy, and higher Lund-Mackay scores (LMSs) were significant clinical predictors of recurrence. TAS2R38 polymorphisms had poorer outcomes, but only 4 trials were included. Asthma, NSAID intolerance, allergy, higher LMS, and TAS2R38 polymorphisms are significant predictors of recurrence in CRS following ESS. These results support the use of comorbidities, radiologic severity, and genetic biomarkers in preoperative risk classification, emphasizing the need for larger, standardized, and multi-ethnic research.