Nasal Dermoplasty for Recurrent Polyps in a Patient with Churg-Strauss Syndrome

Abstract

Nasal dermoplasty for recurrent polyps (NDRP) is a new technique for the surgical treatment of this condition. Churg-Strauss syndrome is characterized by the presence of nasal polyps with a great tendency for relapse after surgical or pharmaceutical treatment. It is the first time that we use NDRP to treat nasal polyps in a patient with Churg-Strauss syndrome. The patient was a 33-year-old female suffering from Churg-Strauss syndrome having had multiple operations in the past for recurrent polyps. NDRP was performed on the left nostril only. The mucosa of the left nasal vault was replaced by a split-thickness skin graft (modified dermoplasty). On the right nostril, polyps were removed and the ostia of the paranasal sinuses were enlarged as in typical endoscopic sinus surgery. The skin graft had a successful take and eight months after the operation no polyps are detected on the left side while polyps have recurred on the right nasal cavity. Applying the technique to a single nostril has several advantages, namely, the reduction of the operational time and therefore the risks for the patient from a prolonged general anaesthetic and the ability to judge the efficacy of the technique on the same patient.

Grafting to denuded nasal cavity for prevention of recurrent nasal polyposis by endoscopic sinus surgery

“…The main complication was foul odour due to graft keratin debris infection, so NDRP was the only technique that might prevent the recurrence of nasal polyposis. 11 Sohail et al studied the smell sensation, 18 (36%) patients would be in mild category, 6 (12%) would be in moderate category and 2 (4%) would be in severe category. 22 patients (44%) would have improvement in the smell sensation after 6 months and were placed in mild category, while 3 patients (6%) would be placed in moderate category and one patient (2%) would be in severe category.…”

A novel use of skin grafting nasal cavity: the severe polyposis

“…Polyps grow no more in the area covered by the graft. In the rest of the nasal mucosa polyps may recur but display a more benign course easily responding to topical therapy even in cases with co-morbidities present that lead to severe polyposis [7]. Our current instruction to our patients is to use eye-drops containing tobramycin/dexamethasone intranasally for one week every three months.…”