Evaluation of the combined medical and surgical treatment in nasal polyposis. I: functional results.
CONCLUSIONS
This prospective study is the first in the literature to present long-term results of a combined medical and surgical treatment in patients with nasal polyposis (NP) including strict inclusion criteria, analysis of the results in terms of clinical amelioration, polyp size reduction, and steroid consumption. The results of the present study show that combined surgery and corticosteroid therapy is effective in the treatment of NP.


OBJECTIVE
Most publications on outcome after functional endoscopic sinus surgery (FESS) include patients with various pathologies. The aim of this study was to provide reference information for FESS in patients with NP with strict inclusion and exclusion criteria.


METHODS
This was a prospective study involving 194 consecutive patients. Clinical symptoms, polyp size, and steroid consumption were evaluated before and after FESS (mean follow-up, 74 months). An actuarial analysis using the Kaplan Meier life table method was performed with regard to the 3- and 5-year symptoms control rates.


RESULTS
All symptoms were improved after FESS. The 5-year actuarial nasal obstruction control rate was 65.8%. The 5-year actuarial severe posterior rhinorrhea control rate was 82.9%. The 5-year actuarial smell loss and anosmia control rates were 17.7% and 65.8%, respectively. Polyp volume and steroid consumption decreased significantly after FESS.
Bonfils
Pierre
P
Department of Oto-Rhino-Laryngology - Head Neck Surgery, European Hospital Georges Pompidou, University Paris-Descartes, Paris, France. pierre.bonfils@egp.aphp.fr
D000280:Administration, Inhalation; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D001507:Beclomethasone / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000000981:diagnostic imaging / Q000628:therapy*; D009298:Nasal Polyps / Q000000981:diagnostic imaging / Q000628:therapy*; D011182:Postoperative Care; D011239:Prednisolone / Q000008:administration & dosage*; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed
D000893:Anti-Inflammatory Agents; D011239:Prednisolone; D001507:Beclomethasone