Endoscopic surgical treatment of sinonasal polyposis-medium term outcomes (mean follow-up of 5 years).
BACKGROUND
Between 30 and 50% of patients with sinonasal polyposis (SNP) will require surgical treatment.


OBJECTIVE
To determine the medium term risks and benefits of endonasal ethmoidectomy in SNP.


METHODS
132 cases of SNP have been retrospectively studied before and after endoscopic nasal surgery with a mean follow-up of 5 years. Functional symptoms and appearances on endoscopic examination were recorded on graded scales. Non-parametric statistical analyses for matched series were used in the assessment of data.


RESULTS
Post-operative normalisation of nasal function was obtained in 62% of cases. Each of the four main nasal symptoms (nasal obstruction, rhinorrhoea, facial pain and anosmia) was improved (p = 0.001). Patients with associated asthma or ASA triad had higher scores for nasal obstruction and rhinorrhoea (Fisher's exact test; p < 0.02). The pre-operative clinical stage of SNP correlated neither with recurrence nor with functional outcomes (Fisher's exact test; p > 0.05). The requirement for steroid treatment of concurrent asthma was also reduced post-operatively (p = 0.001). The association with asthma and its level of treatment was not related to the frequency of recurrence of SNP (Chi2; p > 0.6).


CONCLUSIONS
Functional outcomes for patients with SNP and asthma were significantly improved by endoscopic surgical treatment, even if the appearance of the nasal mucosa did not always return to normal.
Garrel
R
R
Department of Otolaryngology, CHU Montpellier, France. r-garrel@chu-montpellier.fr
Gardiner
Q
Q
Khudjadze
M
M
Demoly
P
P
Vergnes
C
C
Makeieff
M
M
Guerrier
B
B
Crampette
L
L
D001249:Asthma / Q000150:complications / Q000503:physiopathology; D004724:Endoscopy; D005005:Ethmoid Sinus / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000150:complications / Q000601:surgery*; D009364:Neoplasm Recurrence, Local; D010255:Paranasal Sinus Neoplasms / Q000150:complications / Q000601:surgery*; D011127:Polyps / Q000150:complications / Q000601:surgery*; D011182:Postoperative Care; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome