1. Factors Affecting the Control of Chronic Rhinosinusitis With Nasal Polyps : A Comparison in Patients With or Without NERD
- Author
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Lilja, Markus Jukka, Koskinen, Anni, Virkkula, Paula, Vento, Seija Inkeri, Myller, Jyri, Hammaren-Malmi, Sari, Laulajainen-Hongisto, Anu, Hytönen, Maija, Mäkitie, Antti, Numminen, Jura, Sillanpää, Saara, Raitiola, Hannu, Rautiainen, Markus, Toppila-Salmi, Sanna Katriina, HUS Head and Neck Center, Korva-, nenä- ja kurkkutautien klinikka, Department of Dermatology, Allergology and Venereology, HUS Inflammation Center, University of Helsinki, HYKS erva, Päijät-Häme Welfare Consortium, Clinicum, Department of Pathology, Medicum, Tampere University, Department of Otology and Oral Diseases, and Clinical Medicine
- Subjects
RISK ,EOSINOPHIL ,chronic rhinosinusitis ,sinusitis ,computed tomography ,Clinical Trial ,REVISION RATE ,LIFE ,paranasal sinuses ,diagnostics ,RATES ,3125 Otorhinolaryngology, ophthalmology ,RECURRENCE ,ENDOSCOPIC SINUS SURGERY - Abstract
Objectives: The aim was to compare the control of chronic rhinosinusitis with nasal polyps (CRSwNP) after endoscopic sinus surgery (ESS), in patients with/without nonsteroidal anti-inflammatory drug exacerbated respiratory disease (NERD). Study Desing: A retrospective hospital-based sample of CRSwNP patients with/without NERD with follow-up. Setting: Tertiary rhinology centers. Methods: Electronic patient record data from 116 CRSwNP patients (46 with NERD and 70 without NERD) undergoing ESS during 2001-17 were studied. Mean follow-up time was 9.9 years (range 1.1-15.3). Endpoints reflecting uncontrolled CRSwNP were revision ESS, and need for rescue/advanced therapy (e.g. antibiotics, oral corticosteroids and/or biological therapy) during follow-up. NERD was variable of interest and gender, age, asthma, allergic rhinitis (AR), smoking, Lund-Mackay (LM) score of sinus computed tomography scans previous ESS and baseline total ethmoidectomy were used as covariates. Results: Twenty-one (49.7%) NERD patients and 18 (25.7%) non-NERD patients underwent revision ESS within a mean +/- SD of 4.3 +/- 2.8 and 3.7 +/- 2.6 years, respectively (p = .013, by Logrank test). In Cox ' s regression models, NERD, female gender, young age, asthma, AR, previous ESS, and lack of total ethmoidectomy were associated with revision-ESS. In adjusted model, only the total ethmoidectomy predicted revision-free survival. In adjusted logistic regression model, there was an insignificant trend that NERD and LM score were associated with the need for rescue/advanced therapy in the follow-up. Conclusions: Patients with NERD had higher risk of uncontrolled CRSwNP than patient group without NERD, as measured by revision ESS and/or need for rescue/advanced therapy in the follow-up. In addition, baseline total ethmoidectomy was associated with revision-free survival.
- Published
- 2021