Rhinology Online (Jul 2020)
Incidence of secondary atrophic rhinitis following endoscopic sinonasal tumour surgery: a retrospective review
Abstract
Background: Sinonasal tumours have been resected endoscopically at Groote Schuur Hospital, Cape Town, since 2003. The surgery, although called “minimally invasive” is often very aggressive and destructive to the nasal structures. The removal of nasal turbinates has always been considered sacrilege due to the alleged risk of causing atrophic rhinitis. If the theory that atrophic rhinitis follows a simple turbinectomy is indeed true, one would expect all patients undergoing radical resection of the nasal structures to develop atrophic rhinitis. This has not been our experience. Methods: This retrospective case review includes all patients with both benign and malignant sinonasal tumours that were endoscopically resected by a single surgeon from 2006 – 2010 at our institution. We recorded the incidence of postoperative atrophic rhinitis over a 2-year follow-up period. 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 risk of developing symptoms and signs suggestive of atrophic rhinitis. Variables such as age, gender, extent of surgery, bilateral disease, and benign/malignant tumour were not statistically significant in the development of symptoms and signs suggestive of atrophic rhinitis. Conclusions: The extent of endoscopic tumour resections and turbinectomies, even in the presence of roomy nasal cavities, did not predispose to AR. Residual or recurrent disease and those who receive adjuvant radiotherapy have a statistically increased chance of developing symptoms and signs consistent with AR over time. Such patients require careful endoscopic examination to remove crusts and to exclude residual/recurrent tumour or exposed bone deep to the crusts.
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