Polypectomy compared with ethmoidectomy in the treatment of nasal polyposis.

ABSTRACT

OBJECTIVE: To compare the 3-year results of 2 endoscopic surgical approaches in the management of nasal polyposis. DESIGN: Retrospective medical record review. SETTING: Private or institutional practice. PATIENTS A total of 127 patients with nasal polyposis were operated on by the same surgeon between January 1, 2003, and September 31, 2005. INTERVENTION The patients underwent radical ethmoidectomy (n = 77) and polypectomy (n = 50). MAIN OUTCOME MEASURES: Outcome measures were global functional score, calculated by summing the scores (0-3) of each symptom (congestion, rhinorrhea, anosmia, hyperreactivity, and pain); global anatomical score (GAS), calculated by summing the score of polyp development for each nasal cavity; computed tomography score; adherence to corticosteroid therapy; oral corticosteroid consumption; and complication and subsequent operation rate. Efficacy was evaluated by comparing these data preoperatively and postoperatively (at 3 months, 1 year, and 3 years). RESULTS: The global functional score and GAS were significantly improved 3 years after these techniques were performed (global functional score changes from 8.65 to 3.11 for ethmoidectomy and from 8.15 to 4.2 for polypectomy; GAS, from 5.95 to 1.83 for ethmoidectomy and from 6.57 to 3.58 for polypectomy). Congestion, pain, and GAS were improved to a significantly greater extent in the ethmoidectomy group. The subsequent operation rate for symptomatic polyp recurrence was comparable (9.1% vs 8.0%), with fewer local complications in the polypectomy group. CONCLUSION: Polypectomy seems to represent a valuable alternative in the armamentarium of first-hand surgical procedures for treating nasal polyposis.