Outcomes of revision endoscopic modified Lothrop procedure

Morrissey, David K., Bassiouni, Ahmed, Psaltis, Alkis J., Naidoo, Yuresh and Wormald, Peter-John (2016) Outcomes of revision endoscopic modified Lothrop procedure. International Forum of Allergy and Rhinology, 6 5: 518-522. doi:10.1002/alr.21715

Author Morrissey, David K.
Bassiouni, Ahmed
Psaltis, Alkis J.
Naidoo, Yuresh
Wormald, Peter-John
Title Outcomes of revision endoscopic modified Lothrop procedure
Journal name International Forum of Allergy and Rhinology   Check publisher's open access policy
ISSN 2042-6984
Publication date 2016-05-01
Year available 2016
Sub-type Article (original research)
DOI 10.1002/alr.21715
Open Access Status Not Open Access
Volume 6
Issue 5
Start page 518
End page 522
Total pages 5
Place of publication Hoboken NJ, United States
Publisher John Wiley & Sons
Language eng
Formatted abstract
Endoscopic modified Lothrop procedure (EMLP) is used to treat patients who fail conventional sinus surgery. The failure rate of a primary EMLP is reported to be between 5% and 32%. The failure rate of revision EMLP has not been reported. We present our institutions data regarding the outcome of patients requiring revision EMLP.

Data was collected prospectively. Patients undergoing primary EMLP between January 2001 and December 2013 with a minimum follow-up of 6 months were included. Information related to demographics, asthma status, aspirin sensitivity, 22-item Sino-Nasal Outcome Test (SNOT-22) score, Lund-Mackay scores, intraoperative findings, and endoscopic ostium assessment were collected.

There were 213 primary EMLPs completed with average follow-up of 36 months. The failure rate of primary EMLP was 8.9% (19/213), whereas the failure rate of revision EMLP was 21% (4/19). Risk factors for failure of primary EMLP included the presence of intraoperative pus, more than 5 previous sinus operations and aspirin-exacerbated respiratory disease (AERD). Revision of EMLP was undertaken primarily due to recurrence of nasal polyps or ostium stenosis. Those patients who underwent revision EMLP experienced symptomatic improvement and no major complications following the procedure.

The failure rate of revision EMLP is 21% in our series. The majority of revisions were for nasal polyp recurrence. Revision EMLP is a safe and well-tolerated procedure in the small group of patients that require further surgery. Patients with intraoperative pus present at their initial EMLP, more than 5 previous sinus operations, or AERD are at increased risk of failure.
Keyword Asthma
Endoscopic sinus surgery
Sinus surgery
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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