A recent study reveals that the chances of needing follow-up sinus surgery, which may include the removal of nasal polyps, are heightened if a patient has asthma or is taking antibiotics during their first surgery. Interestingly, advanced age does not appear to affect the likelihood of requiring revision surgery.
Nasal polyps are non-cancerous growths that can sometimes completely obstruct the nasal passages. These polyps typically form alongside prolonged sinus infections, resulting in a condition known as chronic rhinosinusitis with nasal polyps.
To treat chronic rhinosinusitis with nasal polyps, doctors often prescribe corticosteroids to be taken through the nose. As the condition worsens, oral corticosteroids might also be necessary. If medication does not alleviate the issue, surgical removal of the polyps can be performed. While most patients find their condition to be manageable post-surgery, a small fraction may still need revision surgery due to the return of symptoms or the regrowth of polyps.
The research included data from all Finnish adults diagnosed with chronic rhinosinusitis with nasal polyps who underwent endoscopic sinus surgery from January 2012 to December 2018, totaling 3,506 participants. Ages ranged from 42 to 65 years, with male patients making up 72% of the group. Follow-up observations continued until the end of 2019.
Throughout the follow-up period, 15.9% of the patients required at least one revision surgery. It was found that the likelihood of needing such surgery, including nasal polyp removal, increased for patients with asthma or those on antibiotics during their initial procedures. In the case of an average patient—defined as a 55-year-old male—the chance of undergoing revision surgery within three years was 11% for those without asthma or antibiotic prescriptions. This figure rose to 16% for those with either condition and climbed to 23% for patients with both.
Younger patients exhibited a higher rate of revision surgeries. Additionally, the extent of the initial surgical procedure correlated with an increased risk for follow-up surgeries. Patients who frequently required oral corticosteroids prior to their first surgery were also more likely to have multiple revision surgeries.
Professor Sanna Toppila-Salmi from the University of Eastern Finland, who led the study, states, “These findings suggest that individuals with severe chronic rhinosinusitis accompanied by nasal polyps often have asthma. For patients struggling to manage their severe condition despite repeated treatments with antibiotics, oral corticosteroids, and surgeries, exploring additional options like biologics may be beneficial.”
The study recommends that when considering surgery, healthcare providers take into account the patient’s asthma status and their history with antibiotics and oral corticosteroids.
Professor Salmi emphasizes the importance of informing patients that severe forms of the disease may return after surgery, advising that such discussions should occur before any surgical decisions are made.
This research was published in Clinical and Translational Allergy and was conducted in partnership with AstraZeneca, Medaffcon, and Tampere University.
