Diffuse Nasal Polyposis: Postoperative Long‐Term Results after Endoscopic Sinus Surgery and Frontal Irrigation

Abstract

Diffuse nasal polyposis remains a challenge despite recent improvements in endonasal surgery. The purpose of this study is to evaluate the results after a radical complete sphenoethmoidectomy with peroperative and postoperative frontal irrigation in cases of diffuse nasal polyposis. In this prospective study, we include 50 consecutive patients with diffuse nasal polyposis suffering from nasal obstruction, anosmia, and other symptoms of chronic sinusitis. All patients were refractory to medical therapy. In each patient an endoscopic complete sphenoethmoidectomy including total excision of all diseased ethmoid mucosa was performed. Preoperative and postoperative frontal irrigation was performed systematically. The patients were followed closely with serial endoscopic examination, and CT scanning was performed between 2 and 3 years after surgery. There were no complications. Thirty-nine of the 50 patients regained satisfactory olfaction. Partial nasal obstruction persisted in four of the 50 patients. Endoscopically, polyp recurrence was noted in 3% of posterior ethmoids, 23% of anterior ethmoids, and 50% of frontal recesses. We conclude that in cases of refractory and extensive nasal polyposis, a total sphenoethmoidectomy with perioperative frontal irrigation followed by long-term postoperative topical steroid therapy provides excellent improvement or cure with safety and reliability.

Evaluation of the combined medical and surgical treatment in nasal polyposis. I: Functional results

“…No major complications (dural exposure, CSF rhinorrhea, meningitis, injury of internal carotid artery, orbital or ocular complications, and systemic complications) were encountered. This is in agreement with some previous reports [13]. Immediate postoperative complications were only reported in 5% of the patients (limited hemorrhagic complications without blood transfusion, limited septal perforation).…”

Radiological findings in patients undergoing revision endoscopic sinus surgery: a retrospective case series study

“…On the other extreme, some surgeons prefer radical endoscopic surgical techniques to treat advanced inflammatory sinus pathology. Such techniques may involve total sphenoethmoidectomies with extensive mucosal resection [16], and may even involve middle turbinate resection as well [17-19]. …”

Localization of Cystic Fibrosis Transmembrane Conductance Regulator in Epithelial Cells of Nasal Polyps and Postoperative Polypoid Mucosae

“…During postoperative followup, endoscopically identi® able polyp recurrence was noted in 23% of anterior ethmoids and in 50% of the frontal recess (10). In addition to remote recurrence of polyps, patients who underwent intranasal surgery frequently manifested with polypoid mucosae or recurrent polyps during the follow-up period of 1± 2 months postoperatively.…”