A long-term follow-up study of nasal polyp patients after simple polypectomies

Abstract

A long-term follow-up study was performed on randomly selected patients after simple snare polypectomies. There were 243 patients, of whom 211 underwent endoscopic examination. There were 154 males and 57 females and median age was 57.7 years. Median period of follow-up was 8 years (range, 38–145 months). The median number of polypectomies was 1.6 (range, 1–15). Polyp eosinophilia was recorded in 97% of the cases. From life-table analysis the 5-year rate for two or less polypectomies was 80% (95% confidence intervals, 75–86%). Symptoms and findings were recorded at a median time of 56 months from the last polypectomy. At this time 70% of the patients denied blocked nose or excessive secretions. Seventeen per cent of the group claimed loss of sense of smell, while 28% stated that it was poor. At follow-up, large polyps were found in 3% of the patients, moderately sized ones in 30% and small in 42%. No polyps were visible in 25%. Patients with asthma (26%) had more polypectomies than those without (median, 2.4 versus 1.4). Patients with a history of non-steroidal anti-inflammatory drug intolerance (7%) had the highest number of polypectomies. Previous troublesome sinusitis and allergy seemed not to exert major influence on the number of polypectomies needed. In the primary care of nasal polyp patients, the majority only need minor or limited surgery or only medical treatment.