The burden of revision sinonasal surgery in the UK – Data from the Chronic Rhinosinusitis Epidemiology Study (CRES); a cross sectional study

Philpott, Carl ORCID:, Hopkins, Claire, Erskine, Sally, Kumar, Nirmal, Robertson, Alasdair, Farboud, Amir, Ahmed, Shahzada, Anari, Shahram, Cathcart, Russell, Khalil, Hisham, Jervis, Paul, Carrie, Sean, Kara, Naveed, Prinsley, Peter, Almeyda, Robert, Mansell, Nicholas, Sunkaraneni, Vishnu, Salam, Mahmoud, Ray, Jaydip, Panesaar, Jaan, Hobson, Jonathan, Clark, Allan ORCID: 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). ISSN 2044-6055

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Objectives/Hypothesis: 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 CRS patients 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%) of 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 to 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 (chi-squared p < 0.001).   Conclusions: This study demonstrated 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
Additional Information: This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: Data sharing statement Additional data can be accessed via the Dryad data repository at with the doi:10.5061/dryad.kt32c.
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Pure Connector
Date Deposited: 30 Apr 2015 15:10
Last Modified: 21 Oct 2022 00:38
DOI: 10.1136/bmjopen-2014-006680

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