When CRSwNP fails to respond to medical therapy, ESS plays an integral role in management. Some studies have shown that MTR during ESS leads to decreased polyp recurrence and revision ESS rates. Other studies suggest MTR can lead to complications.

The purpose of this study was to assess the safety of MTR during ESS for CRSwNP by determining the incidences of CSF leak, postoperative epistaxis requiring operative intervention, and postoperative complete frontal stenosis.

Patients with medically refractory CRSwNP underwent primary or revision ESS plus MTR by three surgeons. Two of the surgeons performed partial MTRs, and one of the surgeons performed complete MTRs.

Unilateral or bilateral complete ESSs with MTRs were performed on 91 CRSwNP patients. Two surgeons performed 97 partial MTRs on 49 patients, and the third surgeon performed 76 complete MTRs on 42 patients. One CSF leak occurred during partial MTR. No patients suffered postoperative epistaxis requiring operative intervention, and no patients developed complete frontal stenosis.

The study concluded that partial and complete MTR during ESS for CRSwNP in this cohort resulted in low, acceptable intraoperative and short-term postoperative complication rates and no detriment to SNOT-22 scores.

Reference: https://journals.sagepub.com/doi/full/10.1177/1945892419860299