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Endoscopic Cholesteatoma Surgery
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Long-term revision rates for endoscopic sinus surgery.

Kristine A Smith1,2, Richard R Orlandi2, Gretchen Oakley2

  • 1Department of Otolaryngology-Head and Neck Surgery, University of Manitoba, Winnipeg, MB, Canada.

International Forum of Allergy & Rhinology
|December 21, 2018
PubMed
Summary

The long-term revision rate for endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS) exceeds 15%. Specific patient factors like female gender, older age, nasal polyps, asthma, and allergies increase the risk for revision ESS.

Keywords:
chronic rhinosinusitisendoscopic sinus surgerypatient factorsrevision surgeryrisk factors

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Area of Science:

  • Otolaryngology
  • Surgical Outcomes Research

Background:

  • Revision rates for endoscopic sinus surgery (ESS) in chronic rhinosinusitis (CRS) show significant variability.
  • Previous studies on ESS revision rates were limited by short follow-up periods, specific academic centers, or small surgeon cohorts.
  • Identifying long-term revision rates and associated patient risk factors for ESS is crucial.

Purpose of the Study:

  • To determine the long-term revision rates for endoscopic sinus surgery (ESS).
  • To identify unique patient factors that elevate the risk for revision ESS in patients with chronic rhinosinusitis (CRS).

Main Methods:

  • Utilized the Utah Population Database to identify patients undergoing ESS between 1996 and 2016.
  • Collected patient demographics and comorbid diagnoses.
  • Employed Cox proportional hazard modeling to analyze revision rates and identify risk factors.

Main Results:

  • A total of 29,934 patients were analyzed with a mean follow-up of 9.7 years.
  • The overall long-term revision rate for ESS was 15.9%.
  • Female gender, older age at initial surgery, nasal polyps, asthma, allergies, and a family history of CRS were significant risk factors for revision surgery (p < 0.001).

Conclusions:

  • The long-term revision rate for ESS surpasses 15%, with decreasing time intervals between repeat surgeries.
  • Specific patient characteristics are associated with an increased likelihood of requiring revision ESS.
  • Understanding these patient-specific risk factors can aid clinicians in patient selection and counseling for ESS.