Endoscopic Sinus Surgery for Chronic Rhino Sinusitis with Nasal Polyps: Predictive Factors of Recurrence.

Background

Chronic rhinosinusitis with nasal polyps (CRSwNP) is an inflammatory condition which may have a significant impact on quality of life. Endoscopic sinus surgery (ESS) is usually indicated for patients' refractory to maximal medical treatment and presents high recurrence and revision surgery rates.

Objective

The aims of this study are to evaluate ESS outcome in CRSwNP management and to assess independent predictive factors for recurrence.

Methods

Retrospective medical chart review of patients who underwent ESS for recalcitrant CRSwNP, from January 2002 to December 2021, with a minimum follow-up time of 12 months.

Results

This study enrolled 280 patients; 52.5% of whom were males, with a mean age of 41.44 ± 14.25 years. Asthma was the most common comorbidity (36.4%, n = 102) and aspirin exacerbated respiratory disease was present in 16.8% (n = 47) of the study population. We found a recurrence rate of 20.7% (n = 58) and 8.9% (n = 25) of patients required revision surgery. Multivariate analysis identified as independent variables of recurrence (95% CI): no compliance with medication after surgery using topical steroids (OR = 16.056; CI 7.887-32.684; P < .001).

Conclusions

ESS proved to be an effective treatment in CRSwNP but with a considerable rate of recurrence. These results indicated an important correlation of postoperative topical steroids compliance with disease recurrence.