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Upper respiratory disease, sinusitis, and polyposis

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Abstract

Historically, surgeons have been reluctant to operate on the sinuses of the patient with CF. They are high-risk patients from both pulmonary and anesthetic standpoints, their medical management can be difficult, and they may have coagulopathy. But perhaps the greatest negative factor has been the previous experience of poor surgical results. The best results have shown a 35% recurrence rate for nasal polyps following combined Caldwell-Luc, intranasal ethmoidectomy and polypectomy procedures (23). In contrast, the recent Stanford experience not only supports the fact that patients with CF can safely undergo surgery, but also strongly supports the feasibility of long-term relief of symptoms with a reasonably low recurrence rate (27% over three years) when combined with the use of direct serial intracavitary sinus lavage with tobramycin forPseudomonas infection. Furthermore, reduction in hospitalization rates postoperatively for selected patients has been documented (34).

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  1. Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, Stanford University School of Medicine, Palo Alto, CA

    Victoria van B. King

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  1. Victoria van B. King
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King, V.v.B. Upper respiratory disease, sinusitis, and polyposis. Clinical Reviews in Allergy 9, 143–157 (1991). https://doi.org/10.1007/BF02914539

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