R456 – Managing Nasal Polyps with Minimally Invasive Surgery

Problem To assess disease-specific short and long term quality-of-life outcomes after minimally invasive surgery (MIS) with Bipolar Radiofrequency Interstitial thermotherapy (RFITT) and CO2 laser, in patients with nasal polyps. Methods Selected nasal polyp patients, with or without previous surgery who failed at medical management, were included in a prospective observational outcome study. CT, bacteriological and histological studies were performed. We used a validated outcome instrument, the nasal obstruction symptom evaluation (NOSE AOHNS) completed by the patients both before and after (1 – 12 months) the procedure. Statistical analysis ANOVA of repeated measures. We managed the obstruction using RFITT, laser and endoscopes, in office-based procedures under local anesthesia. Results Significant improvement was seen in NOSE score a month after the procedure, unchanged at month 12 (basal NOSE 93.75 ± 9.5 vs NOSE 1 month 7.3 ± 8.39 and NOSE 12 months 14.38 ± 11, p 0.0001). No differences were detected between single or multiple polyposis, or septoplasty. No pain, complication or need for packaging. Increase of secretions was referred the first week, some crusting the first month. Very high (78,04%) and moderate (21,95%) patient satisfaction. Patients with previous surgery (46%) keenly consider MIS for future treatments. Conclusion Nasal polyps would be treated with MIS using CO2 laser and RFITT with significant improvement in disease specific quality of life that remains stable for the first year, and very high patient satisfaction with an almost pain free, low risk, fast office-based procedure. Significance It's a promising technique for those who are focusing in clinical outcomes, quality of life, and patient satisfaction. Support No grants. Supported by the School of Medicine Northeastern University Argentina.