Surgical Management of Massive Nasal Polyps

Abstract

Objective:  To assess the different surgical procedures used for management of bilateral massive nasal polyps.

Design:  Descriptive Study.

Place and duration of Study:  Study was conducted in Otorhinolaryngology Department Unit-II King Edward Medical University and Mayo Hospital Lahore, from January 2009 till January 2010.

Patients and Methods:  Patients with massive bilateral nasal polyps were studied. Of these 60 patients were included in the study, irrespective of age and gender. Data including age, gender, socioeconomic status, signs, symptoms, and imaging studies (Computed Tomography and / or Magnetic Resonance Imaging) were noted for the study. Pre and postoperative medical treatment, surgery performed, follow-up; residual / recurrence disease and revised surgery performed were also recorded.

Results:  In the series bilateral nasal polyposis disease of middle age group, with more male patients (60%) Allergic Rhinitis (100%), nasal obstruction (100%) nasal discharge (98%) post nasal drip (98%), Sinusitis (100%) were the commonest presenting features. Surgical management was preferred in all cases as medical management had failed. Endoscopic Sinus Surgery in all cases was done. Recurrence / Residual disease was same in only 11 percent cases.

Conclusion:  Bilateral nasal polyposis is disease of middle age people, males are affected slightly more. Sinusitis and allergic rhinitis are associated symptoms. Medical management with steroid nasal spray is the first line of treatment, if the symptoms and signs persists then surgery is the main treatment. Functional endoscopic surgery with or without powered devices is the surgical method of choice in NP.

Key Words:  Allergic rhinitis, Bilateral Nasal Polyposis, Endoscopic Surgery (FESS).