Twelve-year follow-up study after endoscopic sinus surgery in patients with chronic rhinosinusitis with nasal polyposis

Abstract

Background Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a therapeutic challenge because of the high recurrence rate. Surgical intervention should be considered in patients who fail to improve after medical treatment. We monitored recurrence and revision surgery over 12 years after endoscopic sinus surgery in CRSwNP patients. Methods In this prospective cohort study, 47 patients with CRSwNP, who underwent primary or revision extended endoscopic sinus surgery, were followed. Clinical symptoms and total nasal endoscopic polyp score were evaluated before, 6 years and 12 years after surgery. Results Twelve years after surgery, 38 out of 47 patients (80.9%) were available for examination. There still was a significantly better symptom score and total nasal endoscopic polyp score compared to before surgery (P < 0.001). Within the 12-year follow-up period, 30 out of 38 patients developed recurrent nasal polyps, of which 14 patients underwent additional revision surgery. Comorbid allergic sensitization and tissue IL-5 levels were found to be significant predictors for the need of revision surgery. Conclusions This long-term cohort study, investigating the outcome after surgery in CRSwNP, showed that, despite the low number of patients, 78.9% of patients with CRSwNP were subject to recurrence of the disease and 36.8% to revision surgery over a 12-year period. Electronic supplementary material The online version of this article (10.1186/s13601-019-0269-4) contains supplementary material, which is available to authorized users.

Real‐life assessment of chronic rhinosinusitis patients using mobile technology: The mySinusitisCoach project by EUFOREA

“…FESS is a treatment option for CRS patients with uncontrolled disease despite pharmaceutical treatment 19 . Managing nasal polyps in CRSwNP patients remains a therapeutic challenge with recurrence rates at 1 year after FESS of 38% and at 12 years after surgery in up to 78.9% of patients 20,21 . In the latter study, revision surgery took place in 36.8% of patients over the 12‐year period 20 .…”

Systematic literature review of the epidemiology and clinical burden of chronic rhinosinusitis with nasal polyposis

“…The prevalence of uncontrolled CRSwNP among the general CRSwNP population is not reported in the literature. Only two studies from Belgium have reported 41.8% and 40% uncontrolled CRSwNP among the CRSwNP population who previously had surgery for NP 22,23 .…”

Some Features of Clinical Laboratory and Instrumental Research in Chronic Inflammatory Diseases of the Nose and Paranasal Sinuses in Patients with Myocarditis

“…In recent years, there has been a significant increase in the number of diseases of the nose and paranasal sinuses both in absolute numbers and as a percentage of the total number of ear, nose and throat (ENT) diseases - [1,5]. According to some authors, over the past decade, the number of cases of sinusitis per 1000 people has increased from 4.6 to 12.2.…”

“…Factors that violate the patency of the natural openings of the paranasal sinuses and the mechanisms of their aeration and cleansing include abnormalities of the development of the nasal concha, curvature of the nasal septum, and deformation of the nasal valve, whose functions have not yet been fully studied [2,3,9,12]. The rendered pathological action creates the conditions for blockade of the ostiomeatal complex, and subsequently the development of the inflammatory process in the paranasal sinuses [4,5,6,7,9,11]. In conditions of stagnation of the secret and a decrease in the partial pressure of oxygen in the PNS, favorable conditions are created for the development of a bacterial infection [12,13,14,15].…”

“…Impaired cardiovascular function can occur in approximately 80% of patients with various acute infectious diseases [5,7]. Most of them are a natural functional response of the body, complete independently, without additional special treatment.…”