• Saudi Med J · Dec 2023

    Risk factors for recurrence of chronic rhinosinusitis with nasal polyps after endoscopic sinus surgery: A retrospective study.

    • Yahya A Fageeh, Mohammed A Basurrah, Khalid T Hakami, Zohour A Almalki, Farah S Alnemari, and Wahaj A Altalhi.
    • From the Otolaryngology - Head & Neck Surgery (Fageeh, Basurrah), College of Medicine; and College of Medicine & Surgery, (Almalki, Alnemari, Altalhi) Taif University; and from the Department of Otolaryngology, Head & Neck Surgery (Hakami), Alhada Armed Forces Hospital, Taif City, Kingdom of Saudi Arabia.
    • Saudi Med J. 2023 Dec 1; 44 (12): 125412591254-1259.

    ObjectivesTo assess the pathophysiological factors leading to chronic rhinosinusitis (CRS) recurrence with nasal polyps (CRSwNP) after endoscopic sinus surgery (ESS) and compare the clinical and imaging findings between both groups.MethodsA retrospective study was carried out at a tertiary hospital. Patients with recurrent nasal polyps were compared to those with no recurrence by demographics, risk factors, anatomical abnormalities, clinical features, and Lund-Mackey (LM) scores. Both groups were followed up for 24 months after the primary surgery to detect recurrence.ResultsAmong the 134 patients who underwent ESS for CRSwNP, 69 patients were in the recurrence group and 65 in the non-recurrence group. No significant difference was found in demographics, comorbidities, and anatomical abnormalities between both groups. However, asthma was more prevalent in the recurrence group (73.9% vs. 29.2%; p<0.01). All clinical features were similar between both groups. However, the recurrence group had more patients with bilateral polyps than non-recurrence (95.7% vs. 80%; p<0.01). We found that 26.1% (n=18) of the 69 patients with recurrence needed revision surgery. Smoking rates were significantly different between reoperated vs. non-reoperated patients (16.7% (3/18) vs. 2% (1/51); p=0.02), and the extent of primary ESS was different between them.ConclusionAsthma is a significant risk factor for CRS recurrence. Furthermore, smoking and inadequate primary surgery increase the chance of revision surgery in case of recurrence.Copyright: © Saudi Medical Journal.

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