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Revista ORL
On-line version ISSN 2444-7986
Abstract
DIEZ-GONZALEZ, Laura; MARTIN-VILLARES, Cristina; MARTIN-SIGUENZA, Gerardo and ALVAREZ-ALVAREZ, Ignacio. Review of endoscopic sinus surgery in the era of biologic treatments in a cohort of 388 patients. Rev. ORL [online]. 2023, vol.14, n.3, e31186. Epub Mar 04, 2024. ISSN 2444-7986. https://dx.doi.org/10.14201/orl.31186.
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.
Keywords : nasal polyps; nasal obstruction; FEES; surgical procedures.