(1239) Treatments and Outcomes of Chronic Rhinosinusitis for Individuals With Trisomy 21

Introduction: Individuals with Trisomy 21 often have facial anatomy susceptible to chronic rhinosinusitis (CRS). We sought to understand prevalence of CRS in this population, common treatments, outcomes, and complications.

Methods: Cohorts were created in TriNetX by ICD-10 codes for Trisomy 21 and CRS. Prevalence of CRS in children ( < 18 years) and adults (18 years) was examined. Frequency of treatment for those with Trisomy 21 and CRS was analyzed. Effectiveness (defined by any escalation to endoscopic sinus surgery/ESS) and complication of treatments (within 30 days) were compared to a cohort with CRS but no Trisomy 21 after 1:1 propensity score matching for age, sex, race, ethnicity, and history of asthma or nasal polyps.

Results: Among individuals with Trisomy 21 (n=83,307), 7,007 (8.4%) received CRS diagnosis, including 3,449 children and 3,558 adults. Among those with CRS, 1,096 (15.6%) underwent adenoidectomy, 113 (1.6%) underwent turbinate reduction, and 179 (2.6%) underwent endoscopic sinus surgery. Compared to individuals without Trisomy 21, individuals with Trisomy 21 were not more likely to undergo ESS (or revision ESS) after pediatric adenoidectomy (OR:1.00[0.51-1.97]), turbinate reduction (OR:1.83[0.80-4.19]), or ESS (OR:1.09[0.68-1.74]). Complication rates (including epistaxis, surgical site infection, and abscess) were not significantly different, though analysis was limited by sample size.

Conclusions: Rate of CRS diagnosis among those with Trisomy 21 is similar to that of the US population, suggesting potential underdiagnosis of CRS in individuals with Trisomy 21. Progression to ESS after any initial procedure was not greater than for those without Trisomy 21, suggesting effectiveness of traditional methods for individuals with Trisomy 21. Further studies are required to fully understand clinical response.