Analyse multifactorielle des signes fonctionnels pre-chirurgicaux dans la polypose naso-sinusienne (A propos de 403 patients)

摘要

Purpose: Nasal polyposis is an invading disease whose evolution is dominated by functional symptoms. The aim of this study was to evaluate in cortico-resistant patients with nasal polyps the pre-operative functional symptoms in order to define factors that might increase them. Methods: 403 patients were included in this study. All of them met the inclusion criteria of follow-up and initial examination. Anosmia, pain, nasal obstruction, rhinorrhea and sneezing were evaluated by patients themselves. Radiological data, respiratory function test results and histological data were matched. Results: in our series, functional symptoms were dominated by anosmia, nasal obstruction and rhinorrhea. Pain and sneezing appeared to be less frequent. Analysis of co-variables allowed us to define factors which increased pre-operative functional symptoms. Some of them are well known (such as Fernand-Widal triad or stage 3 nasal polyposis), while others appear new or surprising. The same is true for frontal sinus involvement on CT-scan and glandular hyperplasia on histological study. Conclusion: Analysis of the complete clinical, radiological and histological picture has allowed us to emphasise the importance of certain factors on the functional symptoms of 403 patients with polyps of the nose and sinuses, resistant to steroid treatment. The same is true for Widal's disease, for a higher endoscopic grading, for frontal sinus involvement, and for histological evidence of glandular hyperplasia.