Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-23T19:21:01.019Z Has data issue: false hasContentIssue false
  • English
  • Français

Meticulous endoscopic sinus surgery to prevent recurrence of massive nasal polyposis

Published online by Cambridge University Press:  29 June 2012

S M S Hoseini ,
B Saedi  and
K Aghazadeh
S M S Hoseini
Affiliation:
Otolaryngology Department, Tehran University of Medical Sciences, Iran
B Saedi*
Affiliation:
Otolaryngology Department, Tehran University of Medical Sciences, Iran
K Aghazadeh
Affiliation:
Otolaryngology Department, Tehran University of Medical Sciences, Iran
*
Address for correspondence: Professor B Saedi, Otolaryngology Research Center, Imam Khomeini Medical Center, Bagherkhan Street, Chamran Highway, Tehran, Iran141973141 Fax: 982166581628, E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To evaluate the effect of meticulous endoscopic surgery, including opening of all involved sinus cells, on the subsequent symptoms and endoscopic findings of patients with massive nasal polyposis.

Study design and method:

One hundred patients with massive nasal polyposis resistant to medical treatment were selected. We documented each patient's demographic data, associated diseases, endoscopic findings, Lund–Mackay score and Sino-Nasal Outcome Test 22 (SNOT22) symptom score. All patients were followed up for at least two years to evaluate any recurrence.

Results:

Of the 100 patients, 20 per cent had a history of asthma and 27 per cent had undergone previous surgery. All underwent endoscopic sinus surgery. After two years of follow up, 8 per cent had recurrence requiring surgery. Recurrence was significantly associated with a history of asthma (p < 0.001) and the histopathological presence of eosinophilia (p = 0.014).

Conclusion:

Meticulous endoscopic opening of all involved sinus cells can be a safe and effective means of controlling massive nasal polyposis, with an acceptable recurrence rate.

Keywords

Nasal PolypsSinusitisAsthmaEndoscopic SurgeryPrognosis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 8 , August 2012 , pp. 789 - 794
Copyright
Copyright © JLO (1984) Limited 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Wynn, R, Har-El, G. Recurrence rates after endoscopic sinus surgery for massive sinus polyposis. Laryngoscope 2004;114(5):811–3CrossRefGoogle ScholarPubMed
2 Poetker, D, Mendolia-Loffredo, S, Smith, L. Outcomes of endoscopic sinus surgery for chronic rhinosinusitis associated with sinonasal polyposis. Am J Rhinol 2007;21:84–8CrossRefGoogle ScholarPubMed
3 Smith, T, Loffredo, S, Loehrl, T, Sparapani, R, Laud, W, Nattinger, A. Predictive factors and outcomes in endoscopic sinus surgery for chronic rhinosinusitis. Laryngoscope 2005;115:2199–205CrossRefGoogle ScholarPubMed
4 Dufour, X, Bedier, A, Ferrie, J, Gohler, C, Klossek, J. Diffuse nasal polyposis and endonasal endoscopic surgery: long-term results, a 65-case study. Laryngoscope 2004;114:1982–7CrossRefGoogle ScholarPubMed
5 Bonfils, P, Avan, P. Evaluation of the surgical treatment of nasal polyposis. II: influence of a non-specific bronchial hyperresponsiveness. Acta Otolaryngol 2007;127:847–54CrossRefGoogle ScholarPubMed
6 Tilman, K, Ajnacs, R. Medium-term symptom outcomes after paranasal sinus surgery in children and young adults with cystic fibrosis. Laryngoscope 2007;117:475–9Google Scholar
7 Lavigne, F, Nguyen, C, Cameron, L, Hamid, Q, Ren, M. Prognosis and prediction of response to surgery in allergic patients with chronic sinusitis. Allergy Clin Immunol 2000;105:746–51CrossRefGoogle ScholarPubMed
8 Watelet, JB, Annicq, B, Van Cauwenberge, P, Bachert, C. Objective outcome after functional endoscopic sinus surgery: prediction factors. Laryngoscope 2004;114:1092–7CrossRefGoogle ScholarPubMed
9 Dursun, E, Korkmaz, H, Eryilmaz, A, Bayiz, U, Sertkaya, D, Sami, E. Clinical predictors of long-term success after endoscopic sinus surgery. Otolaryngol Head Neck Surg 2003;129:626–31Google ScholarPubMed
10 Lee, J, Lee, S. Influence of age on the surgical outcome after endoscopic sinus surgery for chronic rhinosinusitis with nasal polyposis. Laryngoscope 2007;117:1084–9CrossRefGoogle ScholarPubMed
11 Cohen, N, Kennedy, D. Revision endoscopic sinus surgery. Otolaryngol Clin North Am 2009;39:188–92Google Scholar
12 Tosun, F, Arslan, H, Karslioglu, Y, Deveci, M, Durniaz, A. Relationship between postoperative recurrence rate and eosinophil density of nasal polyps. Ann Otolaryngol 2010;119:455–9Google ScholarPubMed
13 Musy, Y, Kountakis, E. Anatomic findings in patients undergoing revision endoscopic sinus surgery. Am J Otolaryngol 2004;25:418–22CrossRefGoogle ScholarPubMed
14 Masterson, L, Tanweer, F, Bueser, T, Leong, P. Extensive endoscopic sinus surgery: does this reduce the revision rate for nasal polyposis? Eur Arch Otorhinolaryngol 2010;18:233–7Google Scholar
15 Telmesani, L, Al-Shawarby, M. Osteitis in chronic rhinosinusitis with nasal polyps: a comparative study between primary and recurrent cases. Eur Arch Otorhinolaryngol 2010;267:721–4CrossRefGoogle ScholarPubMed
16 Marchioni, D, Ciufelli, M, Mattioli, F, Marchetti, A, Jovic, G, Massone, F et al. Middle turbinate preservation versus middle turbinate resection in endoscopic surgical treatment of nasal polyposis. Acta Otolaryngol 2008;128:1019–26CrossRefGoogle ScholarPubMed
17 Gerstner, A, Gutschew, M, Cheler, M, Machlittw, J, Emmrichz, F, Sommerer, F et al. Eosinophilia in nasal polyposis: its objective quantification and clinical relevance. Clin Exp Allergy 2004;34:65–70 CrossRefGoogle ScholarPubMed
18 McMains, K, Kountakis, S. Revision functional endoscopic sinus surgery: objective and subjective surgical outcomes. Am J Rhinol 2005;19:344–7CrossRefGoogle ScholarPubMed
19 Hopkins, C, Browne, JP, Slack, R, Lund, V, Topham, J, Reeves, B et al. The national comparative audit of surgery for nasal polyposis and chronic rhinosinusitis. Clin Otolaryngol 2006;31:390–8CrossRefGoogle ScholarPubMed