Revision surgery rates in chronic rhinosinusitis with nasal polyps: meta-analysis of risk factors.

Publication/Presentation Date

2-1-2020

Abstract

BACKGROUND: Wide variations in revision endoscopic sinus surgery (ESS) rates for chronic rhinosinusitis with nasal polyposis (CRSwNP) have been reported. It is important to understand expected revision rates and factors that impact the need for revision.

METHODS: A literature search was conducted on PubMed, Scopus, and the Cochrane Database of Systematic Reviews. Following PRISMA guidelines, a systematic review and meta-analysis was performed on studies that reported revision surgery data for CRSwNP patients.

RESULTS: Forty-five studies with 34,220 subjects were meta-analyzed, with an overall revision rate of 18.6% (95% confidence interval, 14.1%-23.6%). Studies with extractable follow-up data reported a mean revision rate of 16.2% over a weighted mean follow-up of 89.6 months. Factors associated with increased revision rates included allergic fungal rhinosinusitis (28.7%), aspirin-exacerbated respiratory disease (27.2%), asthma (22.6%), prior polypectomy (26.0%), and publication prior to 2008 (22.7%) (p <  0.05 for all).

CONCLUSION: Although polyps can recur after ESS, reported long-term ESS revision rates are approximately 14% to 24%. Identifying risk factors for revision surgery can help manage patient expectations and determine optimal personalized treatments.

Volume

10

Issue

2

First Page

199

Last Page

207

ISSN

2042-6984

Disciplines

Medicine and Health Sciences

PubMedID

31752051

Department(s)

Department of Surgery, Division of Otolaryngology

Document Type

Article

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