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Revision surgery rates in chronic rhinosinusitis with nasal polyps: meta‐analysis of risk factors
Author(s) -
Loftus Catherine A.,
Soler Zachary M.,
Koochakzadeh Sina,
Desiato Vincent M.,
Yoo Frederick,
Nguyen Shaun A.,
Schlosser Rodney J.
Publication year - 2020
Publication title -
international forum of allergy and rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.503
H-Index - 46
eISSN - 2042-6984
pISSN - 2042-6976
DOI - 10.1002/alr.22487
Subject(s) - medicine , nasal polyps , chronic rhinosinusitis , polypectomy , meta analysis , asthma , confidence interval , systematic review , sinusitis , endoscopic sinus surgery , surgery , medline , functional endoscopic sinus surgery , colonoscopy , colorectal cancer , cancer , political science , law
Background Wide variations in revision endoscopic sinus surgery (ESS) rates for chronic rhinosinusitis with nasal polyposis (CRSwNP) have been reported. It is important to understand expected revision rates and factors that impact the need for revision. Methods A literature search was conducted on PubMed, Scopus, and the Cochrane Database of Systematic Reviews. Following PRISMA guidelines, a systematic review and meta‐analysis was performed on studies that reported revision surgery data for CRSwNP patients. Results Forty‐five studies with 34,220 subjects were meta‐analyzed, with an overall revision rate of 18.6% (95% confidence interval, 14.1%‐23.6%). Studies with extractable follow‐up data reported a mean revision rate of 16.2% over a weighted mean follow‐up of 89.6 months. Factors associated with increased revision rates included allergic fungal rhinosinusitis (28.7%), aspirin‐exacerbated respiratory disease (27.2%), asthma (22.6%), prior polypectomy (26.0%), and publication prior to 2008 (22.7%) ( p < 0.05 for all). Conclusion Although polyps can recur after ESS, reported long‐term ESS revision rates are approximately 14% to 24%. Identifying risk factors for revision surgery can help manage patient expectations and determine optimal personalized treatments.