[Recurrence of nasosinusal polyposis after ethmoidectomy by endonasal approach. Functional, endoscopic, x-ray tomographic aspects and surgical implications].

Recurrent polyposis after 116 endonasal ethmoidectomies performed in 61 patients were investigated on the basis of functional, endoscopic and tomodensitometric data. The results of the endoscopic examinations revealed that the anterior ethmoid was involved most often (41%) with either a single localization or in combination with other sites in the sinuses. Functional rhinosinus symptomatology was satisfactory in most cases after a mean follow-up of 22 months, especially for nasal obstruction which was initially predominant (91%). Headaches, especially fronto-orbial localizations, clearly decreased after the operation but there was no correlation between the presence of headache after the operation and the recurrence of the polyposis. Computed tomography gave results similar to those obtained by endoscopy. However, a distinction could not be made between radio-opaque images of polyposis and certain cicatricial or inflammatory reactions. Unlike the functional outcome, ethmoidectomy had little effect on these images. Recurrent polyps appeared most often on the anterior ethmoid and the role of the initial infundibulotomy can be debated. It would appear that the prognosis of polyposis is not modified by extended anterior ethmoidectomy, suggesting that a more conservative surgical approach may be appropriate for frontal ethomoidal polyps.