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;44(12):1254-1259. doi: 10.15537/smj.2023.44.12.20230396.
To 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.
A 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.
Among 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%; <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%; <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); =0.02), and the extent of primary ESS was different between them.
Asthma is a significant risk factor for CRS recurrence. Furthermore, smoking and inadequate primary surgery increase the chance of revision surgery in case of recurrence.
评估内镜鼻窦手术（ESS）后伴鼻息肉的慢性鼻-鼻窦炎（CRSwNP）复发的病理生理因素，并比较两组的临床和影像学表现。
在一家三级医院进行了一项回顾性研究。通过人口统计学、危险因素、解剖异常、临床特征和 Lund-Mackey（LM）评分，将复发鼻息肉患者与无复发患者进行比较。两组均在初次手术后 24 个月内进行随访，以检测复发情况。
在 134 例因 CRSwNP 接受 ESS 的患者中，69 例患者为复发组，65 例为无复发组。两组间的人口统计学、合并症和解剖异常无显著差异。然而，复发组中哮喘更为常见（73.9%比 29.2%；<0.01）。两组间所有临床特征均相似。然而，复发组双侧息肉的患者多于无复发组（95.7%比 80%；<0.01）。我们发现，69 例复发患者中有 26.1%（n=18）需要再次手术。再次手术患者与未再次手术患者的吸烟率有显著差异（16.7%（3/18）比 2%（1/51）；=0.02），且两者的初次 ESS 范围不同。
哮喘是 CRS 复发的一个重要危险因素。此外，吸烟和初次手术不充分会增加复发时需要再次手术的几率。
