The burden of revision sinonasal surgery in the UK-data from the Chronic Rhinosinusitis Epidemiology Study (CRES): a cross-sectional study.

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Philpott, Carl and Hopkins, Claire and Erskine, Sally and Kumar, Nirmal and Robertson, Alasdair and Farboud, Amir and Ahmed, Shahzada and Anari, Shahram and Cathcart, Russell and Khalil, Hisham and Jervis, Paul and Carrie, Sean and Kara, Naveed and Prinsley, Peter and Almeyda, Robert and Mansell, Nicolas and Sunkaraneni, Sankalp and Salam, Mahmoud and Ray, Jaydip and Panesaar, Jaan and Hobson, Jonathan and Clark, Allan and Morris, Steve (2015) The burden of revision sinonasal surgery in the UK-data from the Chronic Rhinosinusitis Epidemiology Study (CRES): a cross-sectional study. BMJ open, 5 (4). e006680. ISSN 2044-6055.

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Official URL: http://bmjopen.bmj.com/content/5/4/e006680.long

Abstract

OBJECTIVES

The aim of this study was to investigate the surgical revision rate in patients with chronic rhinosinusitis (CRS) in the UK CRS Epidemiology Study (CRES). Previous evidence from National Sinonasal Audit showed that 1459 patients with CRS demonstrated a surgical revision rate 19.1% at 5 years, with highest rates seen in those with polyps (20.6%).

SETTING

Thirty secondary care centres around the UK.

PARTICIPANTS

A total of 221 controls and 1249 patients with CRS were recruited to the study including those with polyps (CRSwNPs), without polyps (CRSsNPs) and with allergic fungal rhinosinusitis (AFRS).

INTERVENTIONS

Self-administered questionnaire.

PRIMARY OUTCOME MEASURE

The need for previous sinonasal surgery.

RESULTS

A total of 651 patients with CRSwNPs, 553 with CRSsNPs and 45 with AFRS were included. A total of 396 (57%) patients with CRSwNPs/AFRS reported having undergone previous endoscopic nasal polypectomy (ENP), of which 182 of the 396 (46%) reported having received more than one operation. The mean number of previous surgeries per patient in the revision group was 3.3 (range 2-30) and a mean duration of time of 10 years since the last procedure. The average length of time since their first operation up to inclusion in the study was 15.5 years (range 0-74). Only 27.9% of all patients reporting a prior ENP had received concurrent endoscopic sinus surgery (ESS; n=102). For comparison, surgical rates in patients with CRSsNPs were significantly lower; 13% of cases specifically reported ESS, and of those only 30% reported multiple procedures (χ(2) p<0.001).

CONCLUSIONS

This study demonstrated that there is a high burden of both primary and revision surgery in patients with CRS, worst in those with AFRS and least in those with CRSsNPs. The burden of revision surgery appears unchanged in the decade since the Sinonasal Audit.

Item Type:	Article
Subjects:	WV Otorhinolaryngology. ENT medicine
Divisions:	Ambulatory Care > ENT
Related URLs:	http://www.ncbi.nlm.nih.gov/pubmed/?term...
Depositing User:	Miss Adele Creak
Date Deposited:	01 Jul 2015 14:39
Last Modified:	01 Jul 2015 14:39
URI:	http://www.repository.heartofengland.nhs.uk/id/eprint/1003

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