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Surgery in Nasal Polyp Patients: Outcome After a Minimum Observation of 10 Years.

  • Vlaminck, Stephan1
  • Acke, Frederic2
  • Prokopakis, Emmanuel3
  • Speleman, Kato1
  • Kawauchi, Hideyuki4
  • van Cutsem, Jean-Christophe1
  • Hellings, Peter W5
  • Jorissen, Mark5
  • Seys, Sven5
  • Bachert, Claus2
  • Zele, Thibaut Van2
  • Lambrecht, Bart N6, 7, 8
  • Gevaert, Philippe2
  • 1 Department of Otorhinolaryngology, AZ St-Johns Hospital, Bruges, Belgium. , (Belgium)
  • 2 Department of Otorhinolaryngology, University Hospital, Ghent, Belgium. , (Belgium)
  • 3 Department of Otorhinolaryngology, University of Crete School of Medicine, Crete, Greece. , (Greece)
  • 4 Department of Otorhinolaryngology, University Hospital, Shimane, Japan. , (Japan)
  • 5 Department of Otorhinolaryngology, University Hospital, Leuven, Belgium. , (Belgium)
  • 6 Laboratory of Immunoregulation, VIB Center for Inflammation Research, Ghent, Belgium. , (Belgium)
  • 7 Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium. , (Belgium)
  • 8 Department of Pulmonary Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands. , (Netherlands)
Published Article
American journal of rhinology & allergy
Publication Date
Jul 01, 2021
DOI: 10.1177/1945892420961964
PMID: 33019818


Chronic rhinosinusitis with nasal polyps (CRSwNP) often requires surgery, but recurrence even after surgery is common. Recurrence rates largely vary in literature and asthma seems to be a comorbid factor. In this study, we aim to estimate disease recurrence during a long-term follow-up, together with the investigation of possible predicting and/or influencing parameters. Out of 196 patients operated for CRSwNP between 01/2000 and 01/2006, 133 patients had a follow-up of at least 10 years and could be included. The inflammatory profile at surgery was determined on nasal tissue and sinonasal secretions, and included analysis of eosinophils, eosinophilic-rich mucus (ERM) typically containing Charcot-Leyden crystals (CLC), and fungal hyphae (FH). During follow-up, recurrence, received treatments and comorbidities were collected. Out of the 133 included patients, local eosinophilia was present in 81% and ERM in 60%. Recurrence during follow-up was observed in 62%, and was associated with local eosinophilia and ERM (both p < 0.001). Asthma was present in 28% at inclusion, and 17% developed asthma after surgery during follow-up. The presence of asthma, at inclusion as well as developed during follow-up, was significantly associated with recurrence of CRSwNP (p = 0.001 for group comparison). Recurrence after CRSwNP surgery is common when a long-term follow-up is taken into account. ERM detected in sinonasal secretions at surgery seems to be a predictive factor for recurrence and need for revision surgery. Asthma is a frequently found comorbid factor in CRSwNP, develops even at higher age despite surgical treatment for CRSwNP, and is also associated with a higher recurrence rate. Sustained medical care after surgery is mandatory.

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