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Surgery for chronic rhinosinusitis with nasal polyps: An update.
M Fieux1, C Rumeau2, G De Bonnecaze3
1Service d'ORL, d'otoneurochirurgie et de chirurgie cervico-faciale, hospices civils de Lyon, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France; Université de Lyon, université Lyon 1, 69003 Lyon, France; Université de Paris Est Creteil, Inserm, IMRB, CNRS ERL 7000, 94010 Créteil, France.
Surgery effectively improves quality of life and smell for chronic rhinosinusitis with nasal polyps (CRSwNP). While revision rates are 10-15% at 4 years, disease control can last over a decade, though surgical criteria need clearer definition.
Area of Science:
- Otolaryngology
- Surgical Management
- Rhinology
Background:
- Chronic rhinosinusitis with nasal polyps (CRSwNP) significantly impacts patient quality of life.
- Optimal surgical indications for CRSwNP management remain debated in current literature.
Purpose of the Study:
- To evaluate surgical indications and outcomes for chronic rhinosinusitis with nasal polyps (CRSwNP).
- To synthesize current evidence on the efficacy and long-term control following CRSwNP surgery.
Main Methods:
- A systematic literature search was conducted on PubMed (2006-2021) using keywords 'nasal polyps' and 'surgery'.
- 39 publications were selected and analyzed following Synthesis Without Meta-analysis (SwiM) guidelines.
Main Results:
- Surgery demonstrates established efficacy in improving CRSwNP-related quality of life (SNOT-22 score).
- Approximately 50% of patients experience improved olfactory function post-surgery.
- Surgical revision rates are 10-15% at 4 years, with potential for disease control exceeding 10 years.
Conclusions:
- Surgical intervention offers significant functional benefits for CRSwNP patients.
- Clearer criteria for surgical intervention, such as failure of medical treatment, are suggested.
- Evidence is insufficient to determine the superiority of any specific surgical technique.
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