Recurrence rates in endonasal surgery for polyposis.

OBJECTIVE

To assess the prognostic factors of recurrence in a cohort of patients operated on for polyposis by means of endonasal endoscopic surgery.

METHODS

Prospective study of 227 patients operated on for polyposis in a single institution between 1993 and 2001. The mean follow-up period was 24 months (range 12 months to 60 months). Nine parameters were analysed to study their association with polyp recurrence: age, gender, smoking history, presence of asthma, allergy, non-steroidal anti-inflammatory drugs (NSAID) intolerance, recurrent sinusitis, previous nasal surgery, and polyp extension. Analysis of recurrences was accomplished using the Kaplan-Meier survival curves and differences were analysed using the log-rank test. The Cox proportional hazards model was used to estimate the effect of individual risk factors on polyp recurrence. A probability value of p < 0.05 was the level of significance selected.

RESULTS

During the study period, recurrences developed in 55 patients, giving a rate of 24%. In the univariate analysis, NSAID intolerance, asthma, revision surgery and polyp extension were associated with recidivism. The other mentioned factors did not attain statistical significance. However, the multivariate analysis demonstrated that only NSAID intolerance and asthma are independent predictive factors for recurrence.

CONCLUSIONS

Patients presenting NSAID intolerance or asthma are at risk for the development of recurrences after endonasal surgery for nasal polyposis.