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Multivariate analysis of clinical and radiological risk factors for revision endoscopic sinus surgery in patients with chronic rhinosinusitis with nasal polyps: can phenotype predict recurrence?

Published online by Cambridge University Press:  24 November 2023

Erdem Eren ,
Akif İşlek Open the ORCID record for Akif İşlek [Opens in a new window] ,
Yaşar Batuhan Bakiş  and
Sedat Altay
Erdem Eren
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, İzmir Atatürk Research and Education Hospital, İzmir, Turkey and Izmir University of Economics, Faculty of Medicine, Medical Point Hospital, İzmir, Turkey
Akif İşlek*
Affiliation:
Otolaryngology – Head and Neck Surgery Clinic, Acıbadem Eskişehir Hospital, Eskişehir, Turkey
Yaşar Batuhan Bakiş
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, İzmir Atatürk Research and Education Hospital, İzmir, Turkey and Izmir University of Economics, Faculty of Medicine, Medical Point Hospital, İzmir, Turkey
Sedat Altay
Affiliation:
Radiology Clinic, İzmir Atatürk Research and Education Hospital, İzmir, Turkey
*
Corresponding author: Akif İşlek; Email: drakifislek@gmail.com
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Abstract

Objective

This study aimed to analyse clinical and radiological features (phenotypes) to predict revision risk after functional endoscopic sinus surgery in patients with chronic rhinosinusitis with nasal polyps.

Method

Phenotype characteristics of the patients with chronic rhinosinusitis with nasal polyps who underwent functional endoscopic sinus surgery were analysed retrospectively.

Results

The rates of asthma, aspirin sensitivity, smoking and a positive prick test result were significantly higher in revision functional endoscopic sinus surgery cases (p < 0.001, 0.001, < 0.001 and < 0.001, respectively). Multivariate analysis demonstrated that only gender, pre-operative nasal steroid use, pre-operative systemic steroid use, intra-operative systemic steroid use and smoking were significant risk factors for revision functional endoscopic sinus surgery (p = 0.034, 0.001, 0.010, 0.007 and 0.001, respectively). In addition, only eosinophilia and aspirin sensitivity were significant risk factors for multiple revision functional endoscopic sinus surgery procedures (p = 0.043 and 0.005, odds ratio = 2.4 and 5.2).

Conclusion

Beyond the endotype of chronic rhinosinusitis with nasal polyps, defining clinical and radiological factors enables a valid prediction of patients at high risk of revision functional endoscopic sinus surgery.

Keywords

Rhino-sinusitisnasal polypsinflammationrecurrencephenotypeparanasal sinuses / surgery

Information

Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 138 , Issue 5 , May 2024 , pp. 527 - 534
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Akif İşlek takes responsibility for the integrity of the content of the paper

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