A prospective investigation of predictive parameters for post-surgical recurrences in sinonasal polyposis

• Published in: European archives of oto-rhino-laryngology 2016-03, Vol.273 (3), p.655-660
• Main Authors: Brescia, Giuseppe, Marioni, Gino, Franchella, Sebastiano, Ramacciotti, Giulia, Giacomelli, Luciano, Marino, Filippo, Martini, Alessandro
• Format: Article
• Language: English
• Subjects: Chronic Disease; Female; Head and Neck Surgery; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Nasal Polyps - pathology; Nasal Polyps - surgery; Natural Orifice Endoscopic Surgery - adverse effects; Natural Orifice Endoscopic Surgery - methods; Neoplasm Recurrence, Local; Neoplasm Staging; Neurosurgery; Otorhinolaryngology; Paranasal Sinus Neoplasms - pathology; Paranasal Sinus Neoplasms - surgery; Paranasal Sinuses - pathology; Postoperative Period; Prognosis; Prospective Studies; Recurrence; Rhinitis - complications; Rhinitis - diagnosis; Rhinitis - physiopathology; Rhinology; Sinusitis - complications; Sinusitis - diagnosis; Sinusitis - physiopathology
• ISSN: 0937-4477; 1434-4726
• DOI: 10.1007/s00405-015-3598-5

Even after appropriate surgical therapy, a significant number of patients with chronic rhinosinusitis with nasal polyps (CRSwNP) experience recurrences. The end-point of this prospective study was to apply univariate and multivariate statistical models to identify clinical, pathological, and laboratory variables that could predict CRSwNP recurrence after endoscopic sinus surgery. The study enrolled 143 patients between 2010 and 2013, who were all treated by the same surgeon for CRSwNP. Twenty-one patients developed recurrent polyposis. The recurrence rate was significantly higher for the eosinophilic than for the non-eosinophilic type ( p  = 0.020). Among the patients who developed a recurrence, the disease-free interval was significantly shorter for those with eosinophilic-type polyposis ( p  = 0.003). Univariate statistical analysis disclosed significant associations between CRSwNP recurrence and age ( p  = 0.035), allergy ( p  = 0.014), and eosinophilic granulomatosis with polyangiitis ( p  = 0.01). The multivariate model showed that only histological evidence of the eosinophilic type of CRSwNP retained an independent prognostic significance in relation to recurrent polyposis ( p  = 0.033). Judging from our results, it is reasonable to consider both stricter follow-up protocols and postoperative adjuvant medical treatments for patients with a histological diagnosis of eosinophilic-type CRSwNP.