Can Nasal Polyps Return after Surgery ?

 


Nasal polyps affects more than 10% of the population in western countries, 12% in the United States;6 11% in the Europe and 8-11% in Asia.Chronic rhinosinusitis with nasal polyps (CRSwNP), a phenotype of CRS, is a persistent inflammatory disease of the paranasal sinuses, and in 10%-70% accompanied by asthma. Nasal polyps  is affecting more than 4% of the population, with about a third of patients not controlled with the current standard of care approach, consisting of topical and systemic glucocorticosteroids (GCS), antibiotics and (often repeated) sinus surgery. 

 In the last 15 years, several randomized double-blind studies on monoclonal antibodies in Nasal Polyps were performed. These studies demonstrated for the first time that biologics targeting type 2 immune reactions might be successful in nasal polyps. The target proteins, interleukin (IL)-4, IL-5, IL-13, and IgE were previously identified as key mediators in studies using nasal polyp tissues to measure and to interact in ex-vivo settings. No biomarkers have been identified to predict response to a specific biologic or to monitor treatment success.  

One of the 4 studies was a single center study;13 another involved two centers in Belgium while the other two were multicenter studies across different countries (Table 1). Sample sizes ranged from 23 to 105 sub-jects, with treatment groups ranging from 15 to 54, and controls ranging from 8 to 51 participants. The mean age of eligible patients ranges from 47.4 to 51 years with a bilateral nasal polyp score of at least 5 (out of a maximum score of 8) and at least a score of 2 for each nasal cavity despite intranasal corticosteroid treatment. Patients with prior nasal surgery were accepted.
 Another important patient characteristic is the history of previous endoscopic nasal surgery, with 58%-100% of the participants reporting former surgery for Nasal Polyps. In the latest mepolizumab study,16 severe recurrent bilateral nasal polyposis was an important inclusion criterion, and all patients had surgery/ies before the study inclusion. However, the number of previous operations was not reported in all studies.   Within 18 months of an endoscopic sinus surgery (ESS), 40% of the Nasal polyps patients have been reported with polyp recurrence of disease in three US university clinics

 Read more :  How to Cure Nasal Polyps Permanently and Naturally at Home ?

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