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Surgery for chronic hyperplastic rhinosinusitis.

W H Friedman

    The Laryngoscope
    |December 1, 1975
    PubMed
    Summary
    This summary is machine-generated.

    Bilateral spheno-ethmoidectomy effectively controlled recurrent nasal polyps in 47 of 68 patients, with minimal complications. This surgery, involving complete middle turbinate removal, offers a viable solution for chronic hyperplastic rhinosinusitis.

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    Area of Science:

    • Otolaryngology
    • Allergy and Immunology
    • Surgical Pathology

    Background:

    • Hyperplastic rhinosinusitis presents a challenge in achieving permanent symptom relief.
    • Previous surgical techniques for sinusitis, including polypectomy and turbinate procedures, had varying success rates.
    • Allergic rhinitis and recurrent nasal polyps often necessitate advanced surgical interventions.

    Purpose of the Study:

    • To evaluate the efficacy of bilateral spheno-ethmoidectomy in managing chronic hyperplastic rhinosinusitis with recurrent nasal polyps.
    • To assess the long-term recurrence rates of nasal polyps following this surgical approach.
    • To document the complication rate associated with bilateral spheno-ethmoidectomy.

    Main Methods:

    • A retrospective review of 68 patients who underwent bilateral spheno-ethmoidectomy between 1969 and 1974.

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  • The surgical technique emphasized complete removal of the middle turbinate and opening of the sphenoid air sinus.
  • Patient outcomes were assessed based on polyp recurrence and mucosal manifestations of allergy or infection.

    • Main Results:

    • Forty-seven out of 68 patients (69%) experienced no polyp recurrence between 12 and 60 months post-surgery.
    • Eleven patients had late recurrences of polyps.
    • All patients continued to exhibit allergic or infectious mucosal changes, but polyp recurrence was significantly limited.

    Conclusions:

    • Bilateral spheno-ethmoidectomy, particularly with complete middle turbinate resection, is an effective surgical treatment for chronic hyperplastic rhinosinusitis and recurrent nasal polyps.
    • The procedure demonstrates a favorable long-term polyp control rate.
    • The complication rate of 5.9% was deemed acceptable, with no disabling complications reported.