Manejo quirúrgico de la poliposis nasosinusal
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2010
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Sociedad Chilena de Otorrinolaringología, Medicina y Cirugía de Cabeza y Cuello
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Licencia CC
Licencia CC
Resumen
Introducción: La poliposis nasosinusal es un proceso inflamatorio crónico de la mucosa rinosinusal, de etiología desconocida, y que requiere de tratamiento quirúrgico en más de 50% de los pacientes.
Objetivo: Evaluar los resultados de la cirugía endoscópica en pacientes con poliposis nasosinusal en el Hospital Barros Luco-Trudeau.
Material y método: Estudio retrospectivo de 180 fichas clínicas de pacientes operados en este hospital en el período 1999-2008.
Resultados: La distribución según sexo fue de 63% varones y 37% mujeres (p <0,001) y el promedio etario, de 44,9 años. El motivo principal de consulta fue la obstrucción nasal. Un tercio de los pacientes tenía poliposis masiva. El 17% se asoció con asma. Más del 50% de los pacientes usó corticoides inhalados en el preoperatorio. En el 58% se realizó cirugía endoscópica hasta etmoides anterior. No hubo complicaciones mayores en esta serle estudiada. La recidiva global fue de 24%. El promedio de meses libres de recidiva fue 46,7 meses (IC 95%: 37,5-55,5), con una recidiva de 25% al año de seguimiento. No se encontró asociación entre recidiva y los factores de riesgo estudiados.
Discusión: En comparación con la literatura, se observa similares características demográficas. Sin embargo, los factores de riesgo de recidiva no fueron significativos, aparentemente debido a una baja prevalenciay a pérdida del seguimiento. La tasa de recidiva aumenta con el tiempo, motivo por el cual se requiere un seguimiento a largo plazo.
Conclusiones: No se detectó asociación entre recidiva y los factores de riesgo clásicamente descritos en la literatura. Las recidivas fueron tardías y se obtuvieron tasas de recidiva similares a lo publicado en la literatura.
Introduction: Sinonasal polyposis is a chronic inflammatory process rhinosinusal mucosa of unknown etiology which in over 50% of patients requires surgical treatment. Aim: To evaluate the results of endoscopic surgery in patients with sinonasal polyposis in the Barros Luco-Trudeau Hospital. Material and method: Retrospective study of 180 medical records of patients operated at this hospital from 1999 to 2008. Results: The sexual distribution was 63% male and 37% women (p <0.001). The average age was 44.9years. The chief complaint was nasal obstruction. A third of the patients had massive polyposis. The 17% was associated with asthma. Over 50% of patients used inhaled corticosteroids preoperatively in 58% performed endoscopic surgery to anterior ethmoid. There were no major complications in these series studied. The overall recurrence was 24%. The average number of months free of recurrence was 46.7 months (95% Cl 37.5 to 55.5) with a recurrence of 25% per year of follow up. We found no association between recurrence and the risk factors studied. Discussion: Comparing with the lierature, we see the same demographic characteristics but risk factors for recurrence are not significant, apparently due to the low prevalence and loss of follow-up. The recurrence rate is increased over time and therefore requires a long-term monitoring. Conclusions: We found no association between recurrence and the risk factors classically described in literature. Recurrences were late and we had similar recurrence rates to publish in the lierature.
Introduction: Sinonasal polyposis is a chronic inflammatory process rhinosinusal mucosa of unknown etiology which in over 50% of patients requires surgical treatment. Aim: To evaluate the results of endoscopic surgery in patients with sinonasal polyposis in the Barros Luco-Trudeau Hospital. Material and method: Retrospective study of 180 medical records of patients operated at this hospital from 1999 to 2008. Results: The sexual distribution was 63% male and 37% women (p <0.001). The average age was 44.9years. The chief complaint was nasal obstruction. A third of the patients had massive polyposis. The 17% was associated with asthma. Over 50% of patients used inhaled corticosteroids preoperatively in 58% performed endoscopic surgery to anterior ethmoid. There were no major complications in these series studied. The overall recurrence was 24%. The average number of months free of recurrence was 46.7 months (95% Cl 37.5 to 55.5) with a recurrence of 25% per year of follow up. We found no association between recurrence and the risk factors studied. Discussion: Comparing with the lierature, we see the same demographic characteristics but risk factors for recurrence are not significant, apparently due to the low prevalence and loss of follow-up. The recurrence rate is increased over time and therefore requires a long-term monitoring. Conclusions: We found no association between recurrence and the risk factors classically described in literature. Recurrences were late and we had similar recurrence rates to publish in the lierature.
Notas
Indexación: Scielo
Palabras clave
Cirugía endoscópica, Poliposis nasosinusal, Rinosinusitis crónica, Endoscopic surgery, Sinonasal polyposis, Chronic rhinosinusitis
Citación
Revista de otorrinolaringología y cirugía de cabeza y cuello, Vol. 70, N° 1, pp. 7-16, 2010.