A comparative clinical profile of patients undergoing FESS and septoplasty in Qassim region: shifting focus to diabetic status, synechiae formation and surgical outcomes

Abstract Background Synechiae is a common complication that develops following sinonasal surgical interventions to correct sinonasal disorders. Understanding patients’ clinical profiles and synechia development is crucial for their improved surgical outcomes and overall quality of life. Methods This was a retrospective cohort study that investigated 662 complete medical records of patients who underwent functional endoscopic sinus surgery (FESS) and/or septoplasty between January 2019 and January 2025 at King Fahad Specialist Hospital in Qassim, Saudi Arabia. Data were cleaned, coded and analyzed using SPSS version 27 to obtain crucial insights. Results The study found that the majority of diabetic patients with poor glycemic control developed synechiae, however, the association was not statistically significant ( p = 0.269). In univariate analyses, diabetes mellitus ( p < 0.001), diagnosis ( p < 0.001), and type of surgery ( p < 0.001) were significantly associated with postoperative synechiae development. However, in multivariable logistic regression, only chronic rhinosinusitis remained an independent predictor of synechiae formation (AOR = 3.45, 95% CI = 1.11–10.75, p = 0.033). Multivariate results found diagnosis with chronic rhinosinusitis (AOR = 3.45; 95% CI = 1.106– 10.752; p = 0.033) to be significantly associated with postoperative synechiae development. Additionally, presence of comorbidities (AOR = 2.04; 95% CI = 1.285–3.222; p = 0.002) and previous sinonasal surgery (AOR = 0.18; 95% CI = 0.071– 0.440; p < 0.001) were significant predictors of CRS symptoms recurrence. Conclusion The study found the presence of chronic rhinosinusitis to be a significant positive predictor of postoperative synechiae development. Furthermore, presence of comorbidities was associated with chronic rhinosinusitis symptoms recurrence. The study highlights the need for proper perioperative strategies and careful management of post-operative outcomes for high risk patients.