Erlanger long-term follow-up after endoscopic pansinus surgery in patients with chronic rhinosinusitis with nasal polyposis

Introduction With increasing drug-based therapeutic options and insufficient overall long-term results, the surgical therapy of chronic rhinosinusitis with polyps (CRSwNP) is questioned critically.

Methods In this prospective clinical study 61 patients were included who had undergone bilateral endoscopic pansinus surgery for CRSwNP at the ENT clinic of the University Hospital Erlangen between 2005 and 2010. After 12-17 years the collective was examined for recurrences.

Results 39 of 61 patients (61.9%) were successfully contacted by telephone, 27 patients (44.3%) were examined clinically. 38.5% (n=15) reported a recurrence of CRSwNP. 25.6% (n=10) underwent revision surgery and 2.6% (n=1) received biologicals. Since the initial surgery, 41.0% (n=16) have received corticosteroids systemically or topically. 60% (n=23) of the patients denied any nasal obstruction and rhinorrhea, 82.1% (n=32) cephalgia, 74.4% (n=29) sneezing and 51.3% (n=20) olfactory impairment. In clinical examination, 33.3% (n=9) remained recurrence-free, 14.8% (n=4) achieved a nasal polyp score (NPS) of 1, 18.5% (n=5) of 2, 11.1% (n=3) of 3, 14.8% (n=4) of 4 and 7.4% (n=5) of 5. Taking all findings into consideration, 69.5% (n=27) developed a recurrence of CRSwNP.

Conclusion Including all information, up to 17 years after initial bilateral endoscopic pansinus surgery 69.5% of the patients developed recurrence of CRSwNP. Clinically, 66.7% have a NPS ≥1 and at the same time a low burden of disease. Thus, endoscopic pansinus surgery continues to have an important role in the treatment of CRSwNP. Nevertheless, because of the high recurrence rate, multimodality therapy is required for the targeted and complete treatment of CRSwNP.

Publication History

Article published online:
12 May 2023