Health-related quality of life after polypectomy with and without additional surgery

OBJECTIVE: The objective of this study was to compare the health-related quality of life of patients undergoing simple polypectomy with that of patients undergoing polypectomy with additional surgery. STUDY DESIGN: This was a prospective, multicenter cohort study of adults undergoing sinonasal surgery. METHODS: Eight hundred forty-four patients received simple polypectomy and 1,004 patients received polypectomy with additional surgery. Health-related quality of life was compared at 12 and 36 months after surgery using the Sino-Nasal Outcome Test (SNOT-22). Total SNOT-22 scores may range from zero to 110 with lower scores representing better outcomes. We used linear regression to adjust postoperative SNOT-22 scores for baseline characteristics. When comparing the difference between the two surgical techniques, positive SNOT-22 scores represent a better outcome for those undergoing additional surgery. RESULTS: There were only small differences between the two groups at 12 months (difference in SNOT-22 -0.5; 95% confidence interval [CI] = -2.3-1.3; P = .58) and 36 months after surgery (difference -2.1; 95% CI = -4.4-0.2; P = .08). The additional surgery group had a slightly higher risk of excessive perioperative bleeding (8.6% vs. 6.0%; P = .04) but a slightly lower risk of revision surgery within 36 months (10.4% vs. 13.3%; P = .12). CONCLUSIONS: Nasal polypectomy with additional surgery seems to have no benefit over simple polypectomy in terms of health-related quality of life improvement for patients with nasal polyposis.