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.
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.
Authors: Junqin Bai; Julia H Huang; Caroline P E Price; Jacob M Schauer; Lydia A Suh; Regan Harmon; David B Conley; Kevin C Welch; Robert C Kern; Stephanie Shintani-Smith; Anju T Peters; Whitney W Stevens; Atsushi Kato; Robert P Schleimer; Bruce K Tan Journal: J Allergy Clin Immunol Date: 2022-03-16 Impact factor: 14.290
Authors: Robert Naclerio; Fuad Baroody; Claus Bachert; Benjamin Bleier; Larry Borish; Erica Brittain; Geoffrey Chupp; Anat Fisher; Wytske Fokkens; Philippe Gevaert; David Kennedy; Jean Kim; Tanya M Laidlaw; Jake J Lee; Jay F Piccirillo; Jayant M Pinto; Lauren T Roland; Robert P Schleimer; Rodney J Schlosser; Julie M Schwaninger; Timothy L Smith; Bruce K Tan; Ming Tan; Elina Toskala; Sally Wenzel; Alkis Togias Journal: J Allergy Clin Immunol Pract Date: 2020-03-04
Authors: Ryan E Little; Rodney J Schlosser; Timothy L Smith; Kristina A Storck; Jeremiah A Alt; Daniel M Beswick; Jess C Mace; Jose L Mattos; Vijay R Ramakrishnan; Zachary M Soler Journal: Int Forum Allergy Rhinol Date: 2020-07-26 Impact factor: 3.858
Authors: Amarbir S Gill; Kristine A Smith; Huong Meeks; Gretchen M Oakley; Karen Curtin; Laurie LeClair; Heather Howe; Richard R Orlandi; Jeremiah A Alt Journal: Int Forum Allergy Rhinol Date: 2021-02-24 Impact factor: 5.426