| dc.description.abstract | Introduction and objectives: Endoscopic sinonasal surgery is the procedure of choice in the
treatment of chronic rhinosinusitis and sinonasal polyposis refractory to medical treatment,
with high rates of success (76%-97.5%). However, 2.5%-24% of those patients will require
revision surgery (RESS). In this study, we present the clinical, anatomical, radiological and
histological features of patients receiving RESS in our centre during a 3-year period.
Methods: A retrospective review of clinical, anatomical, radiological and histopathological data
of patients receiving revision endoscopic sinonasal surgery between 2012 and 2014 was carried
out.
Results: From 299 surgery procedures performed, 27 (9%) were revision surgeries. The mean
patient age was 46 years, with a male/female ratio of 1.4/1. The most frequent preoperative
and postoperative diagnosis was chronic polypoid rhinosinusitis. The mean time since
the previous surgery was 6.1 years, with 11.9 months of mean follow-up since that surgery.
Stenotic antrostomy was found during revision in 81.5% of the patients and incomplete anterior
ethmoidectomy and persistent uncinate process, in 59.3%. In radiology, 70.4% of patients had
persistent anterior ethmoidal cells. Antrostomy or widening of antrostomy was performed in
96.3% of cases and anterior ethmoidectomy or completion of it was performed in 66.7%.
Conclusions: Polyps, stenotic antrostomy and incomplete ethmoidectomy were the most frequent
causes of revision surgery, in concordance with the procedures performed. The patients
had long periods of time without follow-up between surgeries. Further investigation is necessary
to generate measures to reduce the number of revision surgeries. | |
