Retrospective investigation of prognostic factors in patients treatedfor chronic rhinosinusitis with nasal polyps

In this study, we aimed to find clinical, radiological and hematological differences between patients with chronic rhinosinusitis (CRS) undergoing revision and primary endoscopic sinus surgery (ESC). We aimed to find out the effects of asthma, aspirin sensitivity and atopy on incidence of revision ESC, where recurrences are more common. In addition, we evaluated the paranasal sinus computed tomography (PNBT) findings to determine the severity of the disease, previous surgery and complications. In the retrospective clinical data analysis, 204 patients who were treated with nasal polyps were evaluated. In this study, we compared 108 patients who underwent 108 primary ESC and 96 revision ESC for nasal polyposis in our clinic between 2008-2019. Examining the files of patients; Sex, age, number of operations, presence of asthma, aspirin sensitivity, additional systemic disease, preop and postop endoscopy findings, skin prick test results, blood eosinophil level and preop PNBT findings were determined. In addition, preop PNBT was examined in the revision ESC group; Surgical failures and complications were detected. In our study, patients with asthma (p=0,07), aspirin sensitivity (p=0,038), skin prick test positivity (p=0,016) and Samter triad (p=0,016) were risky for revision ESC. patients. In addition, the disease was more severe in the revision ESC group. Preop endoscopic polyp stage (p=0,003) and Lund-Mackay CT score (p=0,001) were higher. There was no statistically significant difference in sex, blood eosinophil levels and osteitis. When we look at the surgeon's experience in the recurrence of polyps, there was no significant difference. When the preop PNBTs of the revision ESC group were examined, mostly unopened cells and lateralized middle turbinate were observed. As a result, comorbid diseases of nasal polyp patients should be well defined and treated accordingly. In addition, preop PNBTs should be well examined to prevent surgical failures. Surgical treatment should be performed in detail and meticulously according to the rules.