Eosinophil infiltration of nasal polyps in patients with nasal polyposis: role in clinical evolution after medical and surgical treatment

Objective: In patients with severe nasal polyposis resistant to strict medical treatment, surgery is indicated, but no prognostic factors for surgery efficacy have yet been determined. Some authors suggest that eosinophilic infiltration of nasal polyps could indicate a risk of surgical ineffectiveness. Methods: Surgical plus medical treatment was evaluated over a mean follow-up period of 64 months. One hundred and forty-four subjects were separated into two groups: those with eosinophilic infiltration of >50 per cent (n = 73); and those with <50 per cent infiltration (n = 71). Results: Combined surgery and corticosteroid therapy was effective in the treatment of severe nasal polyposis. No significant difference was found between the two groups in terms of control of nasal obstruction and sense of smell loss. However, a significant difference was found in terms of control of posterior rhinorrhoea (p = 0.01). Conclusion: Eosinophilic infiltration influences the outcome of nasal polyposis surgery, mainly regarding control of posterior rhinorrhoea. It could be considered as a risk factor for surgery in patients with nasal polyposis.