Outcomes of Non-Mucosa Sparing Endoscopic Sinus Surgery (Partial Reboot) in Refractory Chronic Rhinosinusitis with Nasal Polyposis: An Academic Hospital Experience.
chronic rhinosinusitis
endoscopic sinus surgery
oral corticosteroids
partial reboot
reboot surgery
Journal
The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378
Informations de publication
Date de publication:
Jul 2023
Jul 2023
Historique:
revised:
08
09
2022
received:
25
06
2022
accepted:
13
09
2022
medline:
12
6
2023
pubmed:
7
10
2022
entrez:
6
10
2022
Statut:
ppublish
Résumé
The reboot approach could be an effective treatment option to lower recurrence rates (RRs) in recalcitrant Chronic Rhinosinusitis with Nasal Polyps (CRSwNP). The purpose of this study was to investigate RR, recurrence-free survival (RFS), quality of life (QoL) improvement, and oral corticosteroid (OCS) intake in pluri-operated CRSwNP patients treated with partial reboot surgery. A consecutive sample of patients with recalcitrant CRSwNP, ineligible for monoclonal antibodies, underwent partial reboot surgery. The 22-item SinoNasal Outcome Test (SNOT-22), Visual Analogue Scales (VAS) scores, OCS intake, and endoscopic Nasal Polyp Score (NPS) were collected pre and postoperatively. The main outcomes were RR and RFS, and comparison of disease-free time with previous endoscopic surgeries. Thirty pluri-operated patients were enrolled. Before the reboot, all had experienced disease recurrence at a mean recurrence time of 8.08 ± 2.83 months after surgery. After reboot, 7 (23.3%) had recurrence at a mean time of 16.67 ± 3.07 months (p = 0.02); none needed additional revision surgery till time of data collection. RR at 12, 18, and 24 months follow-up resulted significantly lower for reboot than other previous surgeries (p = 0.010, p = 0.002, p = 0.016, respectively); RFS difference resulted significant (log-rank test = 4.16; p = 0.04). Differences between pre-and post-operative total and single-items scores of SNOT-22 were significant (p = 0.001), as well as VAS scores (p = 0.001). Before the reboot, 21 patients (70%) took ≥2 OCS courses per year; at the latest follow-up visit, none had taken any course of OCS after reboot. The reboot approach showed lower RR, longer RFS, improved QoL, and zeroing of OCS uptake. Larger samples and longer follow-up studies are needed to assess long-term efficacy and safety of this procedure. According to the Oxford Center for Evidence-Based Medicine 2011 level of evidence guidelines, this non-randomized retrospective cohort study is classified as level 4 evidence Laryngoscope, 2022. Laryngoscope, 133:1584-1589, 2023.
Substances chimiques
Adrenal Cortex Hormones
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1584-1589Informations de copyright
© 2022 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.
Références
Fokkens WJ, Lund VJ, Hopkins C, et al. European position paper on rhinosinusitis and nasal polyps 2020. Rhinology. 2020;58(Suppl S29):1-464. https://doi.org/10.4193/Rhin20.600.
Centers for Disease Control and Prevention. Chronic Sinusitis - Summary Health Statistics Tables for U.S. Adults: National Health Interview Survey, 2018, Tables A-2b, A-2c. https://ftp.cdc.gov/pub/Health_Statistics/NCHS/NHIS/SHS/2018_SHS_Table_A-2.pdf.
Bachert C, Marple B, Schlosser RJ, et al. Adult chronic rhinosinusitis. Nat Rev Dis Primers. 2020;6(1):86. https://doi.org/10.1038/s41572-020-00218-1.
Heffler E, Malvezzi L, Boita M, et al. Immunological mechanisms underlying chronic rhinosinusitis with nasal polyps. Expert Rev Clin Immunol. 2018;14(9):731-737. https://doi.org/10.1080/1744666X.2018.1512407.
Baiardini I, Paoletti G, Mariani A, et al. Nasal polyposis quality of life (NPQ): development and validation of the first specific quality of life questionnaire for chronic rhinosinusitis with nasal polyps. Healthcare. 2022;10(2):253. https://doi.org/10.3390/healthcare10020253.
Meltzer EO, Hamilos DL, Hadley JA, et al. Rhinosinusitis: establishing definitions for clinical research and patient care. J Allergy Clin Immunol. 2004;114(6, Supplement):155-212. https://doi.org/10.1016/j.jaci.2004.09.029.
Tan R, Cvetkovski B, Kritikos V, et al. Identifying the hidden burden of allergic rhinitis (AR) in community pharmacy: a global phenomenon. Asthma Res Pract. 2017;3:8. https://doi.org/10.1186/s40733-017-0036-z.
Fokkens WJ, Lund V, Bachert C, et al. EUFOREA consensus on biologics for CRSwNP with or without asthma. Allergy. 2019;74(12):2312-2319. https://doi.org/10.1111/all.13875.
Rudmik L, Soler ZM, Hopkins C, et al. Defining appropriateness criteria for endoscopic sinus surgery during management of uncomplicated adult chronic rhinosinusitis: a RAND/UCLA appropriateness study. Int Forum Allergy Rhinol. 2016;6(6):557-567. https://doi.org/10.1002/alr.21769.
Smith TL, Mendolia-Loffredo S, Loehrl TA, Sparapani R, Laud PW, Nattinger AB. Predictive factors and outcomes in endoscopic sinus surgery for chronic rhinosinusitis. Laryngoscope. 2005;115(12):2199-2205. https://doi.org/10.1097/01.mlg.0000182825.82910.80.
DeConde AS, Mace JC, Levy JM, Rudmik L, Alt JA, Smith TL. Prevalence of polyp recurrence after endoscopic sinus surgery for chronic rhinosinusitis with nasal polyposis. Laryngoscope. 2017;127(3):550-555. https://doi.org/10.1002/lary.26391.
Bassiouni A, Wormald PJ. Role of frontal sinus surgery in nasal polyp recurrence. Laryngoscope. 2013;123(1):36-41. https://doi.org/10.1002/lary.23610.
Wormald PJ. Salvage frontal sinus surgery: the endoscopic modified Lothrop procedure. Laryngoscope. 2003;113(2):276-283. https://doi.org/10.1097/00005537-200302000-00015.
Wreesmann VB, Fokkens WJ, Knegt PP. Refractory chronic sinusitis: evaluation of symptom improvement after Denker's procedure. Otolaryngol Neck Surg. 2001;125(5):495-500. https://doi.org/10.1067/mhn.2001.119484.
Bachert C, Zhang N, Hellings PW, Bousquet J. Endotype-driven care pathways in patients with chronic rhinosinusitis. J Allergy Clin Immunol. 2018;141(5):1543-1551. https://doi.org/10.1016/j.jaci.2018.03.004.
Alsharif S, Jonstam K, van Zele T, Gevaert P, Holtappels G, Bachert C. Endoscopic sinus surgery for type-2 CRS wNP: an endotype-based retrospective study. Laryngoscope. 2019;129(6):1286-1292. https://doi.org/10.1002/lary.27815.
Malvezzi L, Pirola F, Virgilio AD, Heffler E. Long-lasting clinical, radiological and immunological remission of severe nasal polyposis by means of “reboot” surgery. BMJ Case Rep CP. 2020;13(4):e233726. https://doi.org/10.1136/bcr-2019-233726.
Gomes SC, Cavaliere C, Masieri S, et al. Reboot surgery for chronic rhinosinusitis with nasal polyposis: recurrence and smell kinetics. Eur Arch Otorhinolaryngol. 2022. Published online June 6, 2022. https://doi.org/10.1007/S00405-022-07470-Z.
Mozzanica F, Preti A, Gera R, et al. Cross-cultural adaptation and validation of the SNOT-22 into Italian. Eur Arch Otorhinolaryngol. 2017;274(2):887-895. https://doi.org/10.1007/s00405-016-4313-x.
DeConde AS, Mace JC, Bodner T, et al. SNOT-22 quality of life domains differentially predict treatment modality selection in chronic rhinosinusitis. Int Forum Allergy Rhinol. 2014;4(12):972-979. https://doi.org/10.1002/alr.21408.
Hopkins C. Chronic rhinosinusitis with nasal polyps. N Engl J Med. 2019;381(1):55-63. https://doi.org/10.1056/NEJMcp1800215.
Hopkins C, Slack R, Lund V, Brown P, Copley L, Browne J. Long-term outcomes from the English national comparative audit of surgery for nasal polyposis and chronic rhinosinusitis. Laryngoscope. 2009;119(12):2459-2465. https://doi.org/10.1002/lary.20653.
Hopkins C, Lund V. Does time from previous surgery predict subsequent treatment failure in chronic Rhinosinusitis with nasal polyps? Rhinol J. 2021;59(3):227-283. https://doi.org/10.4193/Rhin21.017.
Chen FH, Deng J, Hong HY, et al. Extensive versus functional endoscopic sinus surgery for chronic rhinosinusitis with nasal polyps and asthma: a 1-year study. Am J Rhinol Allergy. 2016;30(2):143-148. https://doi.org/10.2500/ajra.2016.30.4271.
Head K, Chong LY, Hopkins C, Philpott C, Burton MJ, Schilder AG. Short-course oral steroids alone for chronic rhinosinusitis. Cochrane Database Syst Rev. 2016;2016(4):CD011991. https://doi.org/10.1002/14651858.CD011991.pub2.
Van Zele T, Gevaert P, Holtappels G, et al. Oral steroids and doxycycline: two different approaches to treat nasal polyps. J Allergy Clin Immunol. 2010;125(5):1069-1076.e4. https://doi.org/10.1016/j.jaci.2010.02.020.
Sullivan PW, Ghushchyan VH, Globe G, Schatz M. Oral corticosteroid exposure and adverse effects in asthmatic patients. J Allergy Clin Immunol. 2018;141(1):110-116.e7. https://doi.org/10.1016/j.jaci.2017.04.009.
Volmer T, Effenberger T, Trautner C, Buhl R. Consequences of long-term oral corticosteroid therapy and its side-effects in severe asthma in adults: a focused review of the impact data in the literature. Eur Respir J. 2018;52(4):1800703. https://doi.org/10.1183/13993003.00703-2018.
Grennan D, Wang S. Steroid side effects. JAMA. 2019;322(3):282. https://doi.org/10.1001/jama.2019.8506.
Heffler E, Bagnasco D, Canonica GW. Strategies to reduce corticosteroid-related adverse events in asthma. Curr Opin Allergy Clin Immunol. 2019;19(1):61-67. https://doi.org/10.1097/ACI.0000000000000493.
Heffler E, Madeira LNG, Ferrando M, et al. Inhaled corticosteroids safety and adverse effects in patients with asthma. J Allergy Clin Immunol Pract. 2018;6(3):776-781. https://doi.org/10.1016/j.jaip.2018.01.025.
Manson SC, Brown RE, Cerulli A, Vidaurre CF. The cumulative burden of oral corticosteroid side effects and the economic implications of steroid use. Respir Med. 2009;103(7):975-994. https://doi.org/10.1016/j.rmed.2009.01.003.
Bhattacharyya N, Villeneuve S, Joish VN, et al. Cost burden and resource utilization in patients with chronic rhinosinusitis and nasal polyps. Laryngoscope. 2019;129(9):1969-1975. https://doi.org/10.1002/lary.27852.
Leung RM, Dinnie K, Smith TL. When do the risks of repeated courses of corticosteroids exceed the risks of surgery? Int Forum Allergy Rhinol. 2014;4(11):871-876. https://doi.org/10.1002/alr.21377.