Incidence of atrophic rhinitis after endoscopic sinonasal surgery : a retrospective review

Master Thesis

2014

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University of Cape Town

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Sinonasal tumours have been resected endoscopically at Groote Schuur Hospital Cape Town South Africa since 2003. Surgery, although seen as minimally invasive because no external incisions are visible, is often very aggressive and destructive to the nasal structures. The removal of the nasal turbinates has always been seen as sacrilege due to the risk of developing atrophic rhinitis. If the theory regarding developing atrophic rhinitis after a simple turbinectomy stands true, one would expect a high incidence of atrophic rhinitis after radical resection of the sinonasal structures. This has not been our experience. METHODS: The study population includes a retrospective case review of all patients that had endoscopic sinonasal tumour resection by the same surgeon between 2006 and 2010. All patients were assessed for symptoms and signs suggestive of atrophic rhinitis up to two years post resection. RESULTS: 51 patients (34M: 17F) were included in the study. Patients with residual or recurrent tumour (n=19) and patients who had received adjuvant radiotherapy (n=17) had a statistically significant chance of developing symptoms and signs suggestive of atrophic rhinitis over time. Variables such as age, gender, extent of surgery, bilateral disease, benign or malignant tumour, were not statistically significant in the development of symptoms and signs suggestive of atrophic rhinitis over time. CONCLUSIONS: Atrophic rhinitis is not more common in patients who undergo endoscopic sinonasal surgery without adjuvant therapy. However, patients with residual tumour (after debulking surgery) or recurrent tumour and those who had received adjuvant radiotherapy had a statistically significant chance of developing symptoms and signs suggestive of atrophic rhinitis over time. Keywords: atrophic rhinitis, endoscopic resection, turbinectomy, medial maxillectomy, sinonasal tumours.
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Includes bibliographical references.

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