Recurrent ethmoidal polypi; a prospective study

OBJECTIVE: To evaluate the various aspects of recurrent ethmoidal polypi and to ascertain the treatment modality for them with the least recurrence. DATA SOURCE AND PERIOD: The study is conducted in 110 patients over two years period [Feb 1995 to Jan 1997], presented in the OPD of the Holy Family Hospital Rawalpindi with Recurrent Ethmoidal Polypi. METHODS: A performa was allocated to every patient to record, present and past history of the disease. H/O allergy, upper respiratory tract infections and family history. Previous treatment modalities either medical or surgical and number of recurrences were noted. Through ENT examination and relevant investigations were carried out. There is predominance of male [68%], adult patients [70%]. Most of the patients presented in winter season, with nasal obstruction 87%, Rhinorrhoea 81%, PND 49%, Sneezing 43% and Headache 42% etc. Previously the patients had conservative treatment 25% and simple polypectomies 64%. Recurrence was treated with medical treatment [anti histamines and topical steroids etc], with about 52.7% success. Repeated polypectomy followed by topical steroids is 60% successful 4 patients required external ethmoidectomy followed by antihistamines with 100% results. in most of the patients recurrence of polypi can be treated by medicinal and meticulously performed simple polypectomy followed by antihistamines and or local steroids. About 5 to 10% patients require extensive surgical operations. External ethmoidectomy is the final court of appeal with 100% results