Reasons for Failure and Complications of Surgery in Diffuse Nasal Polyposis

The most important factor in classification systems is the presence of eosinophilia. All recent theories suggest that the stimulus comes from the nasal mucosal side. The aim of the surgical treatment is to relieve nasal blockage, to improve the symptoms of rhinitis and asthma, and the final target is to eliminate nasal polyps. To have a successful surgical result in recurrent diffuse nasal polyposis patients, all the cells and sinuses should be opened and drained. The mucus should not be allowed to collect in any unopened cells. These areas may serve as triggering points for asthma as well. The surgery should be radical in terms of opening all cells and functional in terms of protecting the nasal mucosa. Close follow-up is of paramount importance in order to prevent edema of the mucosa to close the ostia or cells and initiate the vicious circle again by allowing the mucus to collect between edematous mucosa. Although new technologies may help to lessen the incidence of complications, the safest way to avoid complications is to have enough anatomical knowledge and detailed preoperative evaluation of the patient. The operation should be performed step by step by identifying the landmarks after taking necessary preoperative and operative measurements.