Revision Rates After Endoscopie Sinus Surgery: A Recurrence Analysis.

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Bibliographic Details
Title:	Revision Rates After Endoscopie Sinus Surgery: A Recurrence Analysis.
Authors:	Mendelsohn, Daniel (AUTHOR), Jeremic, Goran (AUTHOR), Wright, Erin D. (AUTHOR), Rotenberg, Brian W. (AUTHOR)
Source:	Annals of Otology, Rhinology & Laryngology. Mar2011, Vol. 120 Issue 3, p162-166. 5p.
Subjects:	Paranasal sinus surgery, Sinusitis treatment, Nasal polyps, Nasal surgery, Analysis of variance, Asthma, Confidence intervals, Endoscopy, Epidemiology, Longitudinal method, Health outcome assessment, Reoperation, Statistical hypothesis testing, Statistics, Surgical complications, Survival analysis (Biometry), Time, Disease relapse, Data analysis, Treatment effectiveness, Proportional hazards models, Therapeutics
Geographic Terms:	Ontario
Abstract:	Objectives: Chronic rhinosinusitis with nasal polyposis is often refractory to medical and surgical management, especially in patients with asthma and aspirin intolerance. We used a contemporary database to investigate recurrence and revision surgery rates following endoscopie sinus surgery. Methods: We performed a cohort study using a survival analysis technique. Records were reviewed of 549 patients with nasal polyposis who underwent endoscopie sinus surgery over a 10-year period. The main outcome measure was disease- free and surgery-free survival following endoscopie sinus surgery, investigated with Kaplan-Meier analyses. Results: Patients with Samter's triad were significantly more likely to have a recurrence and undergo a second surgery following recurrence (risk-odds ratio, 2.7; 95% confidence interval, 1.5 to 3.2; p < 0.01) than were patients without asthma or with only asthma from the triad. The presence of initial frontal sinus disease also increased the likelihood of revision surgery (risk-odds ratio, 1.6; 95% confidence interval, 1.2 to 1.8; p < 0.05). Conclusions: This is the first study to use survival analysis to document revision surgery rates following endoscopie sinus surgery. Revision surgery occurs at a high rate, especially in patients with asthma, Samter's triad, or frontal sinus disease. Patients should routinely be informed during clinical consultations about the likelihood of recurrence. Early intervention for frontal sinus disease may be considered. [ABSTRACT FROM AUTHOR]
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Database:	Psychology and Behavioral Sciences Collection

Description
Abstract:	Objectives: Chronic rhinosinusitis with nasal polyposis is often refractory to medical and surgical management, especially in patients with asthma and aspirin intolerance. We used a contemporary database to investigate recurrence and revision surgery rates following endoscopie sinus surgery. Methods: We performed a cohort study using a survival analysis technique. Records were reviewed of 549 patients with nasal polyposis who underwent endoscopie sinus surgery over a 10-year period. The main outcome measure was disease- free and surgery-free survival following endoscopie sinus surgery, investigated with Kaplan-Meier analyses. Results: Patients with Samter's triad were significantly more likely to have a recurrence and undergo a second surgery following recurrence (risk-odds ratio, 2.7; 95% confidence interval, 1.5 to 3.2; p < 0.01) than were patients without asthma or with only asthma from the triad. The presence of initial frontal sinus disease also increased the likelihood of revision surgery (risk-odds ratio, 1.6; 95% confidence interval, 1.2 to 1.8; p < 0.05). Conclusions: This is the first study to use survival analysis to document revision surgery rates following endoscopie sinus surgery. Revision surgery occurs at a high rate, especially in patients with asthma, Samter's triad, or frontal sinus disease. Patients should routinely be informed during clinical consultations about the likelihood of recurrence. Early intervention for frontal sinus disease may be considered. [ABSTRACT FROM AUTHOR]
ISSN:	00034894
DOI:	10.1177/000348941112000304