DIFFUSE NASAL POLYPOSIS - POSTOPERATIVE LONG-TERM RESULTS AFTER ENDOSCOPIC SINUS SURGERY AND FRONTAL IRRIGATION

Diffuse nasal polyposis remains a challenge despite recent improvement s in endonasal surgery. The purpose of this study is to evaluate the r esults after a radical complete sphenoethmoidectomy with peroperative and postoperative frontal irrigation in cases of diffuse nasal polypos is. In this prospective study we include 50 consecutive patients with diffuse nasal polyposis suffering from nasal obstruction, anosmia, and other symptoms of chronic sinusitis. All patients were refractory to medical therapy, In each patient an endoscopic complete sphenoethmoide ctomy including total excision of all diseased ethmoid mucosa was perf ormed, Preoperative and postoperative frontal irrigation was performed systematically, The patients were followed closely with serial endosc opic examination, and CT scanning was performed between 2 and 3 years after surgery. There were no complications. Thirty-nine of the 50 pati ents regained satisfactory olfaction. Partial nasal obstruction persis ted in four of the 50 patients. Endoscopically, polyp recurrence was n oted in 3% of posterior ethmoids, 23% of anterior ethmoids, and 50% of frontal recesses, We conclude that in cases of refractory and extensi ve nasal polyposis, a total sphenoethmoidectomy with perioperative fro ntal irrigation followed by long-term postoperative topical steroid th erapy provides excellent improvement or cure with safety and reliabili ty.