La polypose naso-sinusienne. Résultats à un an de la chirurgie endoscopique endosinusienne suivie d'une corticothérapie topique chez 72 patients.

Nasal polyposis (NP) is considered as an inflammatory disease for which first line therapy is topical and/or oral corticosteroid. In this paper we attempted to determine the efficacy of endoscopic endonasal surgery followed by topical corticoid in 72 adults suffering from bilateral NP refractory to corticosteroid therapy and to delineate the clinical characteristics of this cohort of patients. NP was confirmed endoscopically and with computed tomography. Visual analog scale for the subjective evaluation and endoscopic examination of the paranasal cavities for the objective evaluation were obtained 3 and 12 months postoperatively. Endoscopic endonasal surgery was based on a radical removal of the NP with wide opening of all the sinuses in the vast majority of the cases. Topical corticoid therapy was started 2 months after surgery.Clinical characteristics of the 72 patients revealed: 29.2% of coexisting allergy; 34.7% of coexisting asthma; 19.4% with food and/or aspirin intolerance. Anterior and posterior ethmoid sinus and maxillary sinus were the most affected sinuses. 53.5% of our patients presented a stage II. One year after surgery we observed that 59.1% of our patients revealed a marked decrease of their symptoms with no polyp on nasal endoscopic evaluation, that 28.8% revealed a marked decrease of their symptoms with recurrence of the NP on nasal endoscopic evaluation and that 12.1% presented moderate to severe symptoms with recurrence of NP on nasal endoscopic evaluation. Based on this experience, we think that endoscopic endonasal surgery will continue to play an important role in the management of NP when the patient becomes refractory to corticoid