Presented at the Triological Society Combined Section Meeting, Scottsdale, AZ, U.S., January 21–23, 2013.
Factors affecting time to revision sinus surgery for nasal polyps: A 25-year experience
Article first published online: 29 JUL 2013
© 2013 The American Laryngological, Rhinological and Otological Society, Inc.
Volume 124, Issue 1, pages 29–33, January 2014
How to Cite
Wu, A. W., Ting, J. Y., Platt, M. P., Tierney, H. T. and Metson, R. (2014), Factors affecting time to revision sinus surgery for nasal polyps: A 25-year experience. The Laryngoscope, 124: 29–33. doi: 10.1002/lary.24213
The authors have no funding, financial relationships, or conflicts of interest to disclose.
- Issue published online: 20 DEC 2013
- Article first published online: 29 JUL 2013
- Accepted manuscript online: 27 MAY 2013 09:43AM EST
- Manuscript Revised: 29 APR 2013
- Manuscript Accepted: 29 APR 2013
- Manuscript Received: 4 JAN 2013
- Nasal polyps;
- chronic rhinosinusitis;
- endoscopic sinus surgery;
- revision sinus surgery
Surgical treatment for chronic rhinosinusitis with nasal polyps (CRSwNP) is often followed by polyp regrowth with return of symptoms. The purpose of this study is to identify clinical factors that influence the time interval to revision sinus surgery in patients with nasal polyps.
Retrospective cohort study.
Records of 299 individuals who underwent two or more surgeries for the diagnosis of nasal polyps by the senior author (RM) from 1987 through 2011 were reviewed. The time between surgical interventions were compared to patient demographics, comorbidities, endoscopic examination, computed tomography (CT) stage, extent of surgery, and pathologic findings.
The mean time interval between polyp surgeries was 4.87 ± 3.61 years (range 0.7–18.6 years). The median time to revision surgery was shorter in patients who smoked compared to nonsmokers (2.82 vs. 4.31 years, respectively, P = .022) and longer in patients who underwent middle turbinate resection rather than preservation (4.56 vs. 3.93 years, respectively, P = .048). Kaplan-Meier survival analysis confirmed these findings, but the beneficial effect of turbinectomy appeared to dissipate by 8 years. Neither a history of asthma nor advanced CT stage influenced the time to revision surgery.
The time course between sinus surgeries in patients with regrowth of nasal polyps appears to be affected by certain modifiable extrinsic factors, including smoking on the part of the patient and operative technique on the part of the surgeon. The performance of middle turbinate resection during sinus surgery appears to extend the time interval until a revision procedure is required.
Level of Evidence
2b. Laryngoscope, 124:29–33, 2014