Evaluation of a Dermoplasty Technique for the Control on Nasal Polyps

Abstract

To evaluate the efficacy of a dermoplasty technique in controlling nasal polyps comparing to the conventional endoscopic approach. Prospective observational study Tertiary private hospital. Twenty-nine patients underwent surgery for replacement of the middle meatus mucosa with skin. Some patients (41.4%) suffered from allergies, 44.8% from asthma, and 27.6% from aspirin intolerance. Polyps were staged according to the Lildholdt system, and patients completed a sino-nasal outcome test (SNOT-22) pre and post-operatively. Also, patients were interrogated as for medication relevant to the nose received pre and post-operatively. In twenty-six patients dermoplasty was applied in one nostril while the contralateral was treated with the conventional endoscopic technique allowing us to compare the two techniques in the same patient. Median follow-up period was 1.2 years (IQR 0.8, 2.0; range 0.4–5.8). Median drop in SNOT-22 score was 38.2 percentage units. Patients (79.3%) controlled symptoms by topical corticosteroids for 2.5–3 months per year at most. Seventy percent (70.8%) reported improvement in subjective olfaction. Results compare favorably to those reported in the literature after functional endoscopic approach. Lildholdt stage dropped post-operatively on both sides but significantly more (p value < 0.001) on the dermoplasty side comparing to the conventional endoscopic side. Dermoplasty appears to outbalance the conventional endoscopic removal of polyps and clearance of paranasal sinuses. No matter how extensive the removal of endonasal tissue, it is not sufficient for controlling nasal polyps unless mucosa is prevented from recovering the denuded areas by the use of a skin graft.