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

Clinical and Translational Allergy 
•   Research
• Open Access

• Lien Calus,
• Nicholas Van Bruaene,
• Cedric Bosteels,
• Sarah Dejonckheere,
• Thibaut Van Zele,
• Gabrielle Holtappels,
• Claus Bachert and
• Philippe GevaertEmail authorView ORCID ID profile

Clinical and Translational Allergy20199:30

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

Fig. 1 Symptoms, expressed as no, mild, moderate or severe are shown as the percentage of study population that experience complaints with the respective severity, at each time point (2000 N = 47, 2006 N = 27 and 2012 N = 24). The percentages are marked in the bars. **P < 0.01; ***P < 0.001

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.

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