Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jan;128(1):31-36.
doi: 10.1002/lary.26741. Epub 2017 Jul 8.

Revision rates and time to revision following endoscopic sinus surgery: A large database analysis

Nathan R Stein  1 , Aria Jafari  1 , Adam S DeConde  1
Affiliations

Revision rates and time to revision following endoscopic sinus surgery: A large database analysis

Nathan R Stein et al. Laryngoscope. 2018 Jan.

Abstract

Objectives/hypothesis: Endoscopic sinus surgery (ESS) is performed for patients with chronic rhinosinusitis (CRS) that have failed maximal medical therapy. This study seeks to determine the prevalence of revision surgery and factors predicting the need for revision after ESS using a large statewide surgery database.

Study design: Large retrospective cohort study using the State Ambulatory Surgery Database for the state of California between 2005 and 2011.

Methods: We identified over 61,000 patients with CRS who underwent ESS, determined by Current Procedural Terminology code. We identified which patients underwent a repeat surgery, and performed multivariable modeling to determine which factors (nasal polyps, age, gender, insurance, hospital setting, ethnicity) predicted the need for revision. Adjusted odds ratios (AOR) and 95% confidence intervals are presented.

Results: Of 61,339 patients who underwent ESS, 4,078 (6.65%) returned for revision ESS during the time period investigated. In a multivariable logistic regression model, positive predictors of revision were a diagnosis of nasal polyps (AOR: 1.20, 95% CI: 1.11-1.29, P < .001) and female gender (AOR: 1.20, 95% CI: 1.11-1.29, P < .001); public insurance was marginally predictive of increased reoperation (AOR: 1.10, 95% CI: 1.00-1.21, P = .048). Patients of Hispanic ethnicity were less likely to have revision surgery (AOR: 0.86, 95% CI: 0.77-0.97, P = .011). Age, income, and hospital setting were not significant predictors.

Conclusions: A minority of patients with CRS who undergo ESS will have a revision surgery. This likelihood is increased in female patients and those with nasal polyps, and decreased in patients of Hispanic ethnicity, even when controlling for income, insurance, and hospital setting.

Level of evidence: 4. Laryngoscope, 128:31-36, 2018.

Keywords: Endoscopic sinus surgery; chronic rhinosinusitis; nasal polyps; revision.

PubMed Disclaimer

Conflict of interest statement

Potential Conflicts of Interest: None

Figures

Figure 1
Figure 1
Kaplan-Meier survival curves for A) entire cohort, and stratified by B) nasal polyposis, C) female gender, D) Hispanic ethnicity
See this image and copyright information in PMC

References

    1. DeConde AS, Soler ZM. Chronic rhinosinusitis: Epidemiology and burden of disease. Am J Rhinol Allergy. 2016;30(2):134–9. - PubMed
    1. Van Oene CM, van Reij EJ, Sprangers MA. Quality-assessment of disease-specific quality of life questionnaires for rhinitis and rhinosinusitis: a systematic review. Allergy. 2007;62(12):1359–71. - PubMed
    1. Bhattacharyya N. Ambulatory sinus and nasal surgery in the United States: demographics and perioperative outcomes. Laryngoscope. 2010;120:635–638. - PubMed
    1. Gliklich RE, Metson R. Effects of sinus surgery on quality of life. Otolaryngol Head Neck Surg. 1997;117:12–17. - PubMed
    1. Wu AW, Ting JY, Platt MP, Tierney HT, Metson R. Factors affecting time to revision sinus surgery for nasal polyps: a 25-year experience. Laryngoscope. 2014;124:29–33. - PubMed

Publication types