Diffuse nasal polyposis and endonasal endoscopic surgery: long-term results, a 65-case study.
OBJECTIVE
To analyze the efficacy of a standardized surgical procedure in patients with nasal polyposis.


METHODS
Prospective study of nonrandomized cases from a single institution.


METHODS
An inception cohort of 65 consecutive patients with nasal polyposis observed from January 1994 to December 1997. Presence of asthma, allergies, or aspirin intolerance, duration of nasal polyposis, previous surgery, and medical treatment were noted. Clinical symptoms were evaluated with a visual analogue scale (VAS), and a preoperative computed tomography scan was performed before the surgical procedure. At the end of the study, an evaluation was performed to collect all information concerning nasal symptoms, asthma conditions, quality of life, and patient's opinion about this type of surgery.


RESULTS
Sixty patients have completed the study. Polyposis was isolated in 29 patients (group A), asthma was present in 21 patients (group B), and aspirin intolerance in 10 patients (group C). Nasal obstruction (n = 53/60, 88.3%) and olfactory disturbances (n = 54/56, 96.4%) were the main preoperative complaints, according to the VAS, with a high degree of severity. No significant difference for nasal symptomatology was found between the three groups. Nasal obstruction and olfactory dysfunction was improved in 37 and 42 patients, respectively, without a statistical significance between the groups. A reduction of the antiasthmatic treatment was observed in 24 of 31 patients. A massive and anteriorly localized recurrence was noted in 3 and 19 patients, respectively.


CONCLUSIONS
Endoscopic sphenoethmoidectomy is indicated for nasal polyposis refractory to intensive medical management with a good improvement of patient's quality of life.
Dufour
Xavier
X
Department of Otorhinolaryngology--Head & Neck Surgery, Centre Hospitalo-Universitaire, Poitiers, France.
Bedier
Arnaud
A
Ferrie
Jean-Claude
JC
Gohler
Catherine
C
Klossek
Jean-Michel
JM
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000601:surgery*; D011446:Prospective Studies; D011795:Surveys and Questionnaires