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Otitis media with effusion in nasal polyposis and outcomes following surgery: A longitudinal observational study
Author(s) -
Lisan Q.,
Rubin F.,
Bonfils P.,
Villeneuve A.
Publication year - 2018
Publication title -
clinical otolaryngology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.914
H-Index - 68
eISSN - 1749-4486
pISSN - 1749-4478
DOI - 10.1111/coa.13201
Subject(s) - medicine , hazard ratio , confidence interval , nasal polyps , effusion , proportional hazards model , surgery , otitis , observational study , cohort , gastroenterology
Objective In patients with nasal polyposis ( NP ), otitis media with effusion ( OME ) seems to be a marker of severity of the inflammatory process occurring in those patients. The aim was to assess whether OME could represent a marker of resistance to the surgical treatment of NP . Design Longitudinal observational cohort study including patients between January 1991 and January 2017. Mean follow‐up was 7.4 years. Setting Tertiary‐care hospital centre. Participants Patients with NP who underwent surgery (radical bilateral sphenoethmoidectomy). Main outcome measures Four outcomes reflecting resistance to the surgical treatment: a clinical score of rhinologic symptoms, the mean number of systemic corticosteroids treatment per year, the recurrence rate of polyps and the rate of reoperation. Results A total of 266 patients were included (63.9% of men, mean age 48 years). In multivariate linear mixed‐effects regression, when compared to patients without OME , patients with OME presented a similar clinical score of symptoms (coefficient 0.09, 95% confidence interval ( CI ) −0.25 to 0.06, P ‐value = 0.24) and a borderline higher mean number of systemic corticosteroids treatments per year (coefficient 0.11, 95% CI 0.003‐0.23, P ‐value = 0.04). In multivariate Cox regression analyses, patients with OME had a similar reoperation rate than patients without OME (hazard ratio ( HR ) 0.29, 95% CI 0.06‐1.50) and a similar recurrence rate of polyps ( HR 0.59, 95% CI 0.23‐1.53). Conclusion In patients with NP , OME is not a marker of surgical resistance. Those patients should be managed similarly than patients without, and similar outcomes following surgery should be expected.