Our Summary

This research paper is about whether or not it’s useful to routinely examine nasal polyps that have been removed during sinus surgery to check for hidden diseases. There isn’t a lot of strong evidence in this area.

The researchers did an extensive review and analysis of six studies involving 3,772 patients. Almost all of these patients had a pre- and post-surgery diagnosis of inflammatory nasal polyps. The researchers found that in almost all cases, the diagnoses matched, meaning that nothing unexpected was found during surgery.

However, there were a few exceptions. In 18 cases, unexpected non-cancerous conditions were found, and in three cases, unexpected cancer was found. This means that for every 210 patients screened, one unexpected non-cancerous condition was found, and for every 1258 patients screened, one unexpected cancer was found.

The cost of finding these unexpected conditions was high - $14,557.20 for each non-cancerous condition and $87,204.56 for each cancerous condition. The cost per year of life saved varied widely depending on different assumptions about how much longer patients lived after their unexpected cancer was found.

In conclusion, the researchers found that routinely checking for hidden diseases in removed nasal polyps might not find many cases. However, they didn’t find strong evidence that this practice should be stopped. They suggest that surgeons should decide on a case-by-case basis whether or not to do these checks.

FAQs

  1. What was the aim of the research study on nasal polyp removal?
  2. What were the findings in terms of unexpected conditions discovered during the examination of removed nasal polyps?
  3. What was the cost associated with finding unexpected non-cancerous and cancerous conditions in removed nasal polyps?

Doctor’s Tip

One helpful tip a doctor might tell a patient about nasal polyp removal is to follow all post-operative care instructions carefully. This may include using prescribed nasal sprays or rinses, avoiding certain activities that could irritate the nasal passages, and attending follow-up appointments with the surgeon. By following these instructions, patients can help promote proper healing and reduce the risk of complications after nasal polyp removal.

Suitable For

Patients who are typically recommended nasal polyp removal are those who have symptoms such as nasal congestion, runny nose, postnasal drip, facial pain or pressure, reduced sense of smell, and frequent sinus infections. These symptoms can be bothersome and can significantly impact a person’s quality of life.

Additionally, patients with nasal polyps that do not respond to conservative treatments such as nasal corticosteroids may also be recommended for nasal polyp removal. Nasal polyps that are large in size, causing significant obstruction of the nasal passages, or are causing complications such as sinus infections or asthma exacerbations may also warrant surgical removal.

Patients who have underlying conditions such as cystic fibrosis, asthma, aspirin-exacerbated respiratory disease, or allergic fungal sinusitis may also be recommended for nasal polyp removal due to the increased risk of recurrent or severe nasal polyps in these populations.

Overall, the decision to recommend nasal polyp removal is based on the severity of symptoms, response to conservative treatments, presence of complications, and underlying medical conditions. It is important for patients to discuss their symptoms and treatment options with their healthcare provider to determine the most appropriate course of action.

Timeline

Before nasal polyp removal, a patient may experience symptoms such as nasal congestion, runny nose, loss of smell, facial pain or pressure, and headaches. These symptoms can impact a patient’s quality of life and may require medication or other treatments to manage.

After nasal polyp removal, patients typically experience relief from their symptoms and improved nasal breathing. Recovery time can vary, but most patients can return to normal activities within a week or two. Some patients may need to continue using nasal sprays or other medications to prevent the recurrence of nasal polyps.

Overall, nasal polyp removal can lead to significant improvements in a patient’s quality of life and ability to breathe comfortably. It is important for patients to follow their doctor’s recommendations for post-operative care to ensure the best possible outcome.

What to Ask Your Doctor

Some questions a patient should ask their doctor about nasal polyp removal include:

  1. What are the potential risks and complications of nasal polyp removal surgery?
  2. What is the success rate of nasal polyp removal surgery in improving symptoms?
  3. How long is the recovery period after nasal polyp removal surgery?
  4. Will I need any follow-up appointments or treatments after nasal polyp removal surgery?
  5. Should I be concerned about the possibility of hidden diseases being found during the surgery?
  6. What is the likelihood of finding unexpected non-cancerous or cancerous conditions during nasal polyp removal surgery?
  7. What are the costs associated with screening for hidden diseases during nasal polyp removal surgery?
  8. How will the decision to screen for hidden diseases be made on a case-by-case basis?
  9. Are there any alternative treatment options for nasal polyps that do not involve surgery?
  10. How can I best prepare for nasal polyp removal surgery and optimize my chances of a successful outcome?

Reference

Authors: Wong JS, Hoffbauer S, Yeh DH, Rotenberg B, Gupta M, Sommer DD. Journal: J Otolaryngol Head Neck Surg. 2015 Nov 4;44:46. doi: 10.1186/s40463-015-0100-8. PMID: 26537414