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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.

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