Document Type

Article

Publication Title

Cureus

Abstract

Background

Septoplasty is frequently performed with functional endoscopic sinus surgery (FESS), either during the same operative session or as a staged procedure. Whether same-day versus staged septoplasty with FESS is associated with differences in postoperative corticosteroid use or postoperative nasal polyp diagnosis remains unclear.

Objective

The study aimed to compare postoperative corticosteroid use and postoperative nasal polyp diagnosis after same-day versus staged septoplasty with FESS.

Methods

We performed a retrospective cohort study using the TriNetX U.S. Collaborative Network. Adults undergoing both septoplasty and FESS were categorized into same-day and staged cohorts, with staged procedures separated by at least 30 days. One-to-one propensity score matching balanced age, sex, race, baseline nasal polyp diagnosis, and baseline systemic and intranasal corticosteroid use. The index date was the FESS procedure date. Postoperative corticosteroid use was assessed from 15 to 180 days after FESS, and postoperative nasal polyp diagnosis was assessed from 15 to 730 days.

Results

After matching, 3,171 patients remained in each cohort. Systemic corticosteroid use occurred in 925 same-day patients (29.17%) and 825 staged patients (26.01%; risk difference, 3.15%; 95% confidence interval (CI), 0.96%-5.35%; odds ratio (OR), 1.17; 95% CI, 1.05-1.31; p = 0.0050). Intranasal corticosteroid use occurred in 1,283 same-day patients (40.46%) and 1,070 staged patients (33.74%; risk difference, 6.72%; 95% CI, 4.35%-9.09%; OR, 1.33; 95% CI, 1.21-1.48; p < 0.0001). Postoperative nasal polyp diagnosis did not differ significantly between cohorts (28.82% vs 26.96%; hazard ratio, 1.08; 95% CI, 0.98-1.18; log-rank p = 0.1189).

Conclusions

Compared with staged surgery, same-day surgery was associated with significantly higher postoperative systemic and intranasal corticosteroid prescribing, but there was no statistically significant difference in postoperative nasal polyp diagnosis between cohorts. These findings are hypothesis-generating and should not be interpreted as evidence that staging reduces total corticosteroid burden or provides equivalent endoscopic disease control. Further prospective studies with standardized medication capture, symptom scores, and endoscopic follow-up are needed to clarify whether surgical timing influences postoperative inflammatory control after septoplasty and FESS.

DOI

10.7759/cureus.114969

Publication Date

8-22-2026

Keywords

corticosteroids, functional endoscopic sinus surgery, nasal polyps, septoplasty, surgical timing

ISSN

2168-8184

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