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Updated: Jul 9, 2025
Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
Risk factors for recurrence of chronic rhinosinusitis with nasal polyps after endoscopic sinus surgery: A
Yahya A Fageeh1, Mohammed A Basurrah1, Khalid T Hakami1
1From the Otolaryngology - Head & Neck Surgery (Fageeh, Basurrah), College of Medicine; and College of Medicine & Surgery, (Almalki, Alnemari, Altalhi) Taif University; and from the Department of Otolaryngology, Head & Neck Surgery (Hakami), Alhada Armed Forces Hospital, Taif City, Kingdom of Saudi Arabia.
Objectives:
To assess the pathophysiological factors leading to chronic rhinosinusitis (CRS) recurrence with nasal polyps (CRSwNP) after endoscopic sinus surgery (ESS) and compare the clinical and imaging findings between both groups.
Methods:
A retrospective study was carried out at a tertiary hospital. Patients with recurrent nasal polyps were compared to those with no recurrence by demographics, risk factors, anatomical abnormalities, clinical features, and Lund-Mackey (LM) scores. Both groups were followed up for 24 months after the primary surgery to detect recurrence.
Results:
Among the 134 patients who underwent ESS for CRSwNP, 69 patients were in the recurrence group and 65 in the non-recurrence group. No significant difference was found in demographics, comorbidities, and anatomical abnormalities between both groups. However, asthma was more prevalent in the recurrence group (73.9% vs. 29.2%; p<0.01). All clinical features were similar between both groups. However, the recurrence group had more patients with bilateral polyps than non-recurrence (95.7% vs. 80%; p<0.01). We found that 26.1% (n=18) of the 69 patients with recurrence needed revision surgery. Smoking rates were significantly different between reoperated vs. non-reoperated patients (16.7% (3/18) vs. 2% (1/51); p=0.02), and the extent of primary ESS was different between them.
Conclusion:
Asthma is a significant risk factor for CRS recurrence. Furthermore, smoking and inadequate primary surgery increase the chance of revision surgery in case of recurrence.
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