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Outcomes of revision endoscopic modified Lothrop procedure
David K Morrissey1,2, Ahmed Bassiouni3,2, Alkis J Psaltis3,2
1School of Medicine, The University of Queensland, Brisbane, Australia.
International Forum of Allergy & Rhinology
|February 17, 2016
Summary
Revision endoscopic modified Lothrop procedures (EMLP) have a 21% failure rate, primarily due to nasal polyp recurrence. This revision surgery is safe and effective for patients needing further treatment after initial EMLP.
Area of Science:
- Otolaryngology
- Rhinology
- Surgical Outcomes
Background:
- Endoscopic modified Lothrop procedure (EMLP) treats patients with failed conventional sinus surgery.
- Primary EMLP failure rates range from 5% to 32%.
- Revision EMLP failure rates are not well-documented.
Purpose of the Study:
- To report institutional data on the outcomes of revision endoscopic modified Lothrop procedures.
- To determine the failure rate of revision EMLP.
- To identify risk factors associated with EMLP failure.
Main Methods:
- Prospective data collection from January 2001 to December 2013.
- Inclusion of patients undergoing primary EMLP with at least 6 months follow-up.
- Collection of demographic, clinical, and surgical outcome data, including SNOT-22 and Lund-Mackay scores.
Main Results:
- Primary EMLP failure rate was 8.9% (19/213).
- Revision EMLP failure rate was 21% (4/19).
- Risk factors for primary EMLP failure included intraoperative pus, >5 prior sinus operations, and aspirin-exacerbated respiratory disease (AERD).
Conclusions:
- Revision EMLP demonstrates a 21% failure rate, mainly for recurrent nasal polyps.
- Revision EMLP is a safe and well-tolerated procedure.
- Intraoperative pus, extensive prior sinus surgery, and AERD increase the risk of EMLP failure.
