Revista ORL

Make a submission

Review of endoscopic sinus surgery in the era of biologic treatments in a cohort of 388 patients

  • Laura Díez-González
    Complejo Asistencia Universitario de León (CAULE). Servicio de Otorrinolaringología. León. España lauradiezg[at]hotmail.com
  • Cristina Martín-Villares
    Complejo Asistencia Universitario de León (CAULE). Servicio de Otorrinolaringología. León. España
  • Gerardo Martín-Sigüenza
    Complejo Asistencia Universitario de León (CAULE). Servicio de Otorrinolaringología. León. España
  • Ignacio Álvarez-Álvarez
    Complejo Asistencia Universitario de León (CAULE). Servicio de Otorrinolaringología. León. España
https://doi.org/10.14201/orl.31186

Abstract

Introduction and objective: To retrospectively review the revision surgical rate in a cohort cohort of a tertiary level hospital to select better strategies for recurrent patients. Method: A retrospective review of patients operated between 2016 and 2020 was carried out. The factors evaluated included epidemiological, surgical, radiological and histopathological data. In recurrences, Lund-Mackay CT score and eosinophil count was performed. Surgical revision rate was investigated. Results: We performed 506 Functional Endoscopic Sinus Surgery (FESS) on 388 patients for five years. Out of them, 78% were chronic rhinosinusitis (CRS). Globally, 18% required revision surgery, highest if they had CRS with polyps and asthma (34%), or aspirin-intolerance (42%). The highest rate of recurrence was on the osteometal complex (73%). Patients with elevate eosinophil count in nasal tissues present a revision surgical rate of 34.2% and an OR of 3.2 (IC95 % 1.2-8.2). Biologic therapy is administrated in 7 patients with severe asthma. Discussion and conclusions: The revision surgery rate for CRS was 18%. Recurrences are frequent in anterior meatal complex. It is important to consider patient-specific factors that affect revision surgery rates such as elevate eosinophil count to find better treatments for these worse patients.
  • Referencias
  • Cómo citar
  • Del mismo autor
  • Métricas
Stammberger H, Posawetz W. Functional endoscopic sinus surgery. Concept, indications and results of the Messerklinger technique. Eur Arch Otorhinolaryngol. 1990;247(2):63-76.

Settipane GA. Epidemiology of nasal polyps. Allergy Asthma Proc. 1996;17(5):231-6.

Wynn R, Har-El G. Recurrence rates after endoscopic sinus surgery for massive sinus polyposis. Laryngoscope. 2004;114(5):811-3.

Loftus CA, Soler ZM, Koochakzadeh S, Desiato VM, Yoo F, Nguyen SA, et al. Revision surgery rates in chronic rhinosinusitis with nasal polyps: meta-analysis of risk factors. Int Forum Allergy Rhinol. 2020;10(2):199-207.

Zhang L, Zhang Y, Gao Y, Wang K, Lou H, Meng Y, et al. Long-term outcomes of different endoscopic sinus surgery in recurrent chronic rhinosinusitis with nasal polyps and asthma. Rhinology. 2020;58(2):126–35.

Gandhi NA, Bennett BL, Graham NMH, Pirozzi G, Stahl N, Yancopoulos GD. Targeting key proximal drivers of type 2 inflammation in disease. Nat Rev Drug Discov. 2016;15(1):35–50.

Bachert C, Han JK, Wagenmann M, Hosemann W, Lee SE, Backer V, et al.; EUFOREA Expert Board Meeting on Uncontrolled Severe Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) and Biologics: Definitions and Management [Internet]. J Allergy Clin Immunol. 2021;147(1):29–36.

Bachert C, Han JK, Desrosiers M, Hellings PW, Amin N, Lee SE, et al. Efficacy and safety of dupilumab in patients with severe chronic rhinosinusitis with nasal polyps (LIBERTY NP SINUS-24 and LIBERTY NP SINUS-52): results from two multicentre, randomised, double-blind, placebo-controlled, parallel-group phase 3 trials. Lancet. 2019;394(10209):1638–50.

Han JK, Bachert C, Fokkens W. SYNAPSE study investigators. Mepolizumab for chronic rhinosinusitis with nasal polyps (SYNAPSE): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Respir Med. 2021;9:1141–53.

Gevaert P, Omachi TA, Corren J, Katial R, Gauvreau GM, Gleich GJ, et al. Efficacy and safety of omalizumab in nasal polyposis: 2 randomized phase 3 trials. J Allergy Clin Immunol. 2020;146(3):595-605.

Lund VJ, Mackay IS. Staging in rhinosinusitus. Rhinology. 1993;31(4):183–4.

Baban MIA, Mirza B, Castelnuovo P. Radiological and endoscopic findings in patients undergoing revision endoscopic sinus surgery. Surg Radiol Anat. 2020;42(9):1003–12.
Díez-González, L., Martín-Villares, C., Martín-Sigüenza, G., & Álvarez-Álvarez, I. (2023). Review of endoscopic sinus surgery in the era of biologic treatments in a cohort of 388 patients. Revista ORL, 14(3), e31186. https://doi.org/10.14201/orl.31186

Most read articles by the same author(s)

1 2 > >> 

Downloads

Download data is not yet available.
+ −