Evaluation of Recurrent Nasal Polyposis in Patients who had Endoscopic Sinus Surgery

Section: Research Paper
Issue
Vol. 48 No. 1 (2026): Volume 48 Issue 1
Pages
68-77

Keywords:

Nasal polyps,, CRSwNP,, Functional Endoscopic Sinus Surgery (FESS), Lund-Kennedy score,, Lund-Mackay CT score

Abstract

Background: Nasal polyposis is a prevalent nasal mucosal disorder that significantly impairs patients' quality of life. Functional endoscopic sinus surgery (FESS) remains the standard treatment. Multiple comorbidities and etiological factors associated with the development and recurrence of nasal polyps, making recurrence a frequent clinical challenge. 


Aim: To identify the most common contributing factors to recurrent nasal polyposis from clinical, endoscopic, radiological, and surgical perspectives. 


Methods: This cross-sectional descriptive study was carried out between January and December 2022 at the Otorhinolaryngology Department of Rizgari Teaching Hospital, Erbil City, Iraq. The study included 32 patients (aged 23–70 years, both males and females). Informed consent was obtained from all participants. Quality of life was assessed using the SNOT-22 questionnaire. Comprehensive clinical histories were taken to identify comorbidities. Preoperative evaluations used the Lund-Kennedy endoscopic scoring system and the Lund-Mackay CT scoring system. Intraoperative findings were recorded and correlated with symptom-free intervals for nasal obstruction.


Results: Allergic rhinitis was present in 60% and asthma in 34% of patients with recurrent nasal polyps. All patients experienced nasal obstruction (unilateral or bilateral) based on SNOT-22; 85% reported loss of taste and smell. About half maintained regular follow-up and medication compliance, which was associated with longer symptom-free periods. Forty-five percent scored above 8 on the Lund-Kennedy scale, and over 85% scored above 7 on the Lund-Mackay CT score. Intraoperatively, aside from nasal polyps, lateralized middle turbinate (45%) and retained uncinate process (30%) were the next most common findings. Higher intraoperative scores were strongly inversely correlated with symptom-free periods (P < 0.001). 


Conclusion: Recurrent nasal polyposis is multifactorial. Major associations with recurrence include comorbidities such as asthma, anatomical variations unaddressed during initial surgery, incomplete removal of ethmoid cells, and retained uncinate processes. 

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Authors

Khalid Jamal Hanna

Moyaser A. Yaseen

Identifiers

DOI: 10.33899/acmm.v48.i1.53831

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1.
Evaluation of Recurrent Nasal Polyposis in Patients who had Endoscopic Sinus Surgery. Ann. coll. Med. Mosul [Internet]. 2026 Jun. 30 [cited 2026 Jul. 18];48(1):68-77. Available from: https://mmed.uomosul.edu.iq/index.php/mmed/article/view/53831

How to Cite

1.
Evaluation of Recurrent Nasal Polyposis in Patients who had Endoscopic Sinus Surgery. Ann. coll. Med. Mosul [Internet]. 2026 Jun. 30 [cited 2026 Jul. 18];48(1):68-77. Available from: https://mmed.uomosul.edu.iq/index.php/mmed/article/view/53831