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Review
. 2023 Nov;137(11):1277-1284.
doi: 10.1017/S0022215123000853. Epub 2023 May 22.

Phenotypic associations of medical polypectomy and revision surgery following endoscopic sinus surgery: a retrospective study of a single-centre experience in Scotland

Rasads Misirovs  1   2 , Rory Chan  1 , Kirsten Stewart  1 , Brian Lipworth  1
Affiliations
Review

Phenotypic associations of medical polypectomy and revision surgery following endoscopic sinus surgery: a retrospective study of a single-centre experience in Scotland

Rasads Misirovs et al. J Laryngol Otol. 2023 Nov.

Abstract

Background: Some chronic rhinosinusitis with nasal polyps patients undergo revision surgery at some point following initial functional endoscopic sinus surgery. This review aimed to identify the predictive factors for recurrence of nasal polyps requiring oral corticosteroids or revision surgery in chronic rhinosinusitis with nasal polyps following functional endoscopic sinus surgery.

Method: A retrospective analysis of 221 patients who underwent functional endoscopic sinus surgery for chronic rhinosinusitis with nasal polyps in a tertiary rhinology centre, between January 2015 and December 2018, was undertaken.

Results: Forty-four (21.6 per cent) patients underwent medical polypectomy, 19 (9 per cent) underwent revision surgery and 51 (24.3 per cent) underwent combined polypectomy during the mean follow-up time of 5.3 years. Patients aged less than 55 years of age, with a history of previous functional endoscopic sinus surgery, peripheral blood eosinophil counts of 300 cells/μl or higher, a Lund-Mackay score of more than 17 and concomitant aspirin-exacerbated respiratory disease had significantly increased odds for medical polypectomy, revision surgery and combined polypectomy.

Conclusion: Knowing these predictive factors, clinicians can better identify patients with an increased likelihood of severe polyp recurrence and therefore arrange closer follow-up to optimise therapy.

Keywords: Corticosteroids; asthma; eosinophils; nasal polyps; sinusitis.

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Figures

Figure 1.
Figure 1.
Patient flow chart. CRSwNP = chronic rhinosinusitis with nasal polyps; AERD = aspirin-exacerbated respiratory disease
Figure 2.
Figure 2.
Adjusted odds ratio for (a) medical polypectomy, (b) revision functional endoscopic sinus surgery (FESS) and (c) combined polypectomy (odds ratios adjusted to age and gender). *p < 0.05; **p < 0.01; ***p < 0.001. PBE = peripheral blood eosinophils; LMS = Lund–Mackay score; CRSwNP = chronic rhinosinusitis with nasal polyps; AERD = aspirin-exacerbated respiratory disease; NS = non-significant (p ≥ 0.05)
See this image and copyright information in PMC

References

    1. Vaidyanathan S, Barnes M, Williamson P, Hopkinson P, Donnan PT, Lipworth B. Treatment of chronic rhinosinusitis with nasal polyposis with oral steroids followed by topical steroids: a randomized trial. Ann Intern Med 2011;154:293–302 - PubMed
    1. Campion NJ, Kohler R, Ristl R, Villazala-Merino S, Eckl-Dorna J, Niederberger-Leppin V. Prevalence and symptom burden of nasal polyps in a large Austrian population. J Allergy Clin Immunol Pract 2021;9:4117–29.e2 - PubMed
    1. Hopkins C, Slack R, Lund V, Brown P, Copley L, Browne J. Long-term outcomes from the English national comparative audit of surgery for nasal polyposis and chronic rhinosinusitis. Laryngoscope 2009;119:2459–65 - PubMed
    1. Fokkens WJ, Lund VJ, Hopkins C, Hellings PW, Kern R, Reitsma S et al. Executive summary of EPOS 2020 including integrated care pathways. Rhinology 2020;58:82–111 - PubMed
    1. Hopkins C. Chronic rhinosinusitis with nasal polyps. N Engl J Med 2019;381:55–63 - PubMed