Evaluation of the surgical treatment of nasal polyposis. II: Influence of a non-specific bronchial hyperresponsiveness

Abstract

Conclusion. Bronchial hyperresponsiveness (BHR) is not a risk factor for surgery in patients with nasal polyposis (NP). Objective. Management of NP should be primarily medical, and surgery should not be envisaged before a trial of dual steroid therapy. In patients with severe NP resistant to a strict medical treatment, endoscopic sinus surgery is performed, but no prognostic factor for efficacy of surgery is obvious. Some authors suggest that asthma could be a major risk for ineffectiveness of surgery. The aim of this study was to evaluate whether the presence of BHR can be considered a risk factor for ineffectiveness of surgery. Subjects and methods. Surgery (with associated medical treatment) was evaluated over a mean follow-up period of 74 months. A total of 63 subjects without and 131 subjects with BHR were operated according to a standardized protocol. Results. The present study shows that combined surgery and corticosteroid therapy is effective in the treatment of severe NP, producing significant and long-term improvements in symptoms and in the size of nasal polyps. BHR did not influence the outcome. Moreover, the mean amount of prednisolone and beclomethasone necessary after surgery was similar in the two groups.