Comparison of functional results after ethmoidectomy and nasalization for diffuse and severe nasal polyposis.

Abstract:

:Taking advantage of a natural experimental situation, we compared, retrospectively, functional results after nasalization and ethmoidectomy for diffuse nasal polyposis. Nasalization was a radical ethmoidectomy systematically removing all the bony lamellae and mucosa within the labyrinth, with large antrostomy, sphenoidotomy, frontotomy, and middle turbinectomy (Surgeon 1, 39 consecutive patients operated on between March and September 1991). Ethmoidectomy was a less systematic procedure, that was adapted to the extent of the pathology (Surgeon 2, 37 consecutive patients, operated on between October 1991 and November 1994). In May 1994, a third physician mailed a questionnaire simultaneously to all patients including 10-point visual analog scales 34/39 patients in the nasalization group (age: 28-71 years: 20 asthmatics; follow-up: 32-36 months), and 29/37 patients in the ethmoidectomy group (age: 26-65 years: 9 asthmatics: follow-up: 18-31 months) participated in the study. The overall nasal improvement was 8.8 +/- 0.2 (mean +/- SEM) after nasalization and 5.9 +/- 0.6 after ethmoidectomy (p = 0.0001). Olfaction improvement was similar in both groups 6 months after surgery, remained at the same level 36 months after nasalization (6.9 +/- 0.7), but decreased to 4.2 +/- 1 points 24 months after ethmoidectomy (p = 0.02). Asthma improvement remained significantly better after nasalization (p = 0.05), and the need for systemic steroids was also lower (p = 0.03). Results of this study suggest that when dealing with nasal polyposis, the more radical the surgery, the better the functional results.

journal_name

Acta Otolaryngol

journal_title

Acta oto-laryngologica

authors

Jankowski R,Pigret D,Decroocq F

doi

10.3109/00016489709113445

subject

Has Abstract

pub_date

1997-07-01 00:00:00

pages

601-8

issue

4

eissn

0001-6489

issn

1651-2251

journal_volume

117

pub_type

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