[Predictive factors for recurrence after surgery of nasal polyposis].

M Sellami, M Mnejja, M Masmoudi, I Charfeddine, B Hammami, A Ghorbel
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Abstract

Introduction: Endoscopic sinus surgery has become the treatment of choice in the surgical management of patients with nasal polyposis. The aim of our study is to identify the role of some epidemiological, clinical and therapeutic factors in recurrence after surgery of nasal polyposis.

Materials and methods: We conducted a retrospective study over a period of 11 years (between 2000 and 2010) including 184 patients operated for nasal polyposis after failure of prolonged medical treatment. We evaluated the impact of epidemiological and clinical factors (age, sex, asthma, Widal disease, allergy and stage of nasal polyposis at the time of surgery) and treatment (surgical technique, observance of postoperative topical steroids ) on postoperative recurrence.

Results: Nasal poly­posis recurred in 26.6% of patients after an average period of 23 months. Widal disease, asthma and bad observance of the intranasal steroid therapy were significantly associated with postoperative recurrence in the univariate analysis. In multi­variate analysis the bad observance of the intranasal steroid therapy was the only factor significantly associated with recurren­ce.

Conclusion: Postoperative steroids prescribed routi­nely in our practice can effectively prevent recurrence after endonasal surgery and this result was found in both uni­variate and multivariate analysis.

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【鼻息肉术后复发的预测因素】。
鼻内窥镜手术已成为鼻息肉患者手术治疗的首选。本研究旨在探讨流行病学、临床及治疗因素在鼻息肉术后复发中的作用。材料和方法:我们进行了一项为期11年(2000年至2010年)的回顾性研究,包括184例长期药物治疗失败后手术治疗鼻息肉病的患者。我们评估了流行病学和临床因素(年龄、性别、哮喘、维达尔病、过敏和手术时鼻息肉分期)和治疗(手术技术、术后局部类固醇治疗)对术后复发的影响。结果:术后23个月鼻息肉复发率为26.6%。在单因素分析中,疾病、哮喘和鼻内类固醇治疗的不良遵守与术后复发显著相关。在多变量分析中,鼻内类固醇治疗的不良遵守是唯一与复发显著相关的因素。结论:术后常规使用类固醇药物可有效预防鼻内手术后复发,单因素和多因素分析均证实了这一结果。
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