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Review
. 2024 Aug 27;16(8):e67910.
doi: 10.7759/cureus.67910. eCollection 2024 Aug.

Factors Contributing to the Recurrence of Chronic Rhinosinusitis With Nasal Polyps After Endoscopic Sinus Surgery: A Systematic Review

Sarah H Abuduruk  1 , Bayan K Sabb Gul  2 , Shuruq M AlMasoudi  3 , Enas H Alfattani  2 , Mouaz A Mohammad  2 , Hind M Alshehri  1 , Ashwaq D Alosaimi  4 , Rakan F Almnjwami  1 , Johara A Alnafie  5 , Ali N Jabbari  1 , Abdulaziz H Althumali  1
Affiliations
Review

Factors Contributing to the Recurrence of Chronic Rhinosinusitis With Nasal Polyps After Endoscopic Sinus Surgery: A Systematic Review

Sarah H Abuduruk et al. Cureus. .

Abstract

Chronic rhinosinusitis with nasal polyposis (CRSwNP) occurs due to the inflammation of sinonasal tissue. Cases of CRSwNP more commonly demand revision endoscopic sinus surgery (ESS) as compared to patients without polyposis. The recurrence rate varies widely depending on various factors, such as the extent of surgery, patient compliance with postoperative care, and the severity of the underlying disease. Studies conducted on chronic rhinosinusitis (CRS) patients showing recurrence or relapse of nasal polyps post endoscopic sinus surgery were included. We used the modified Newcastle-Ottawa scale (NOS) for cross-sectional studies and cohort studies. Only 15 articles met our inclusion and exclusion criteria after the full-text screening. The studies enrolled participants between 2009 and 2022, including 2,515 ESS patients. The mean age of the included subjects ranged between 37.1 and 57.57 years. In conclusion, CRSwNP is a chronic inflammatory disease that can impose a significant burden on patients, healthcare systems, and society. Asthma, aspirin intolerance, peripheral eosinophilia, interleukin-5 (IL-5) expression, T2 profile, and intense sinus opacification have been noted to be independent predictors of the condition in different studies. Recurrent polyposis in CRS signals a more aggressive disease course, requiring close follow-up and revision surgeries in the long run.

Keywords: chronic rhinosinusitis; edema; endoscopic sinus surgery; nasal polyps; recurrence; relapse.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. A PRISMA flow diagram outlining the study selection process
PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses
See this image and copyright information in PMC

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