Endoscopic surgical treatment of sinonasal polyposis-medium term outcomes (mean follow-up of 5 years)

Background: Between 30 and 50% of patients with sinonasal polyposis (SNP) will require surgical treatment. Objective: To determine the medium term risks and benefits of endonasal ethmoidectomy in SNP. Method: 132 cases ofSNP have been retrospectively studied before and after endoscopic nasal surgery with a mean follow-up of 5 years. Functional symptoms and appearances on endoscopic examination were recorded on graded scales. Non-parametric statistical analyses for marched series were used in the assessment of data. Results: Post-operative normalisation of nasal function was obtained in 62% of cases. Each of the four main nasal symptoms (nasal obstruction, rhinorrhoea, facial pain and anosmia) was improved (p=0.001). Patients with associated asthma or ASA triad had higher scores for nasal obstruction and rhinorrhoea (Fisher's exact test; p 0.05). The requirement for steroid treatment of concurrent asthma was also reduced post-operatively (p=0.001). The association with asthma and its level of treatment was not related to the frequency of recurrence of SNP (Chi 2 ; p>0.6). Conclusions: Functional outcomes for patients with SNP and asthma were significantly improved by endoscopic surgical treatment, even if the appearance of the nasal mucosa did not always return to normal.