Evaluation of a Dermoplasty Technique for the Control on Nasal Polyps

  • George AnastasopoulosEmail author
  • Eleftherios Ferekidis
Original Article


To evaluate the efficacy of a dermoplasty technique in controlling nasal polyps comparing to the conventional endoscopic approach. Prospective observational study Tertiary private hospital. Twenty-nine patients underwent surgery for replacement of the middle meatus mucosa with skin. Some patients (41.4%) suffered from allergies, 44.8% from asthma, and 27.6% from aspirin intolerance. Polyps were staged according to the Lildholdt system, and patients completed a sino-nasal outcome test (SNOT-22) pre and post-operatively. Also, patients were interrogated as for medication relevant to the nose received pre and post-operatively. In twenty-six patients dermoplasty was applied in one nostril while the contralateral was treated with the conventional endoscopic technique allowing us to compare the two techniques in the same patient. Median follow-up period was 1.2 years (IQR 0.8, 2.0; range 0.4–5.8). Median drop in SNOT-22 score was 38.2 percentage units. Patients (79.3%) controlled symptoms by topical corticosteroids for 2.5–3 months per year at most. Seventy percent (70.8%) reported improvement in subjective olfaction. Results compare favorably to those reported in the literature after functional endoscopic approach. Lildholdt stage dropped post-operatively on both sides but significantly more (p value < 0.001) on the dermoplasty side comparing to the conventional endoscopic side. Dermoplasty appears to outbalance the conventional endoscopic removal of polyps and clearance of paranasal sinuses. No matter how extensive the removal of endonasal tissue, it is not sufficient for controlling nasal polyps unless mucosa is prevented from recovering the denuded areas by the use of a skin graft.


Chronic rhinosinusitis Endoscopic surgery Nasal polyps Dermoplasty 



Statistical analysis was performed by Nikos Pantazis from the Dept. of Hygiene, Epidemiology and Medical Statistics of the Medical School of the National and Kapodistrian University of Athens.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Fokkens WJ, Lund VJ, Mullol J et al (2012) European position paper on rhinosinusitis and nasal polyps. Rhinol Suppl 2012(23):1–298Google Scholar
  2. 2.
    Devars du Mayne M, Prulière-Escabasse V, Zerah-Lancner F et al (2011) Polypectomy compared with ethmoidectomy in the treatment of nasal polyposis. Arch Otolaryngol Head Neck Surg 137:111–117CrossRefGoogle Scholar
  3. 3.
    Dessouky O, Hopkins C (2015) Surgical versus medical interventions in CRS and nasal polyps: comparative evidence between medical and surgical efficacy. Curr Allergy Asthma Rep 15:66CrossRefGoogle Scholar
  4. 4.
    Bassiouni A, Wormald PJ (2013) Role of frontal sinus surgery in nasal polyp recurrence. Laryngoscope 123:36–41CrossRefGoogle Scholar
  5. 5.
    Morrissey DK, Bassiouni A, Psaltis AJ et al (2016) Outcomes of modified endoscopic Lothrop in aspirin-exacerbated respiratory disease with nasal polyposis. Int Forum Allergy Rhinol 6:820–825CrossRefGoogle Scholar
  6. 6.
    Hopkins C, Rimmer J, Lund VJ (2015) Does time to endoscopic sinus surgery impact outcomes in Chronic Rhinosinusitis? Prospective findings from the National Comparative Audit of Surgery for Nasal Polyposis and Chronic Rhinosinusitis. Rhinology 53:10–17CrossRefGoogle Scholar
  7. 7.
    Hopkins C, Slack R, Lund V et al (2009) Long-term outcomes from the English national comparative audit of surgery for nasal polyposis and chronic rhinosinusitis. Laryngoscope 119:2459–2465CrossRefGoogle Scholar
  8. 8.
    Masterson L, Tanweer F, Bueser T et al (2010) Extensive endoscopic sinus surgery: does this reduce the revision rate for nasal polyposis? Eur Arch Otorhinolaryngol 267:1557–1561CrossRefGoogle Scholar
  9. 9.
    Chen FH, Deng J, Hong HY et al (2016) Extensive versus functional endoscopic sinus surgery for chronic rhinosinusitis with nasal polyps and asthma: a 1-year study. Am J Rhinol Allergy 30:143–148CrossRefGoogle Scholar
  10. 10.
    Jankowski R, Pigret D, Decroocq F (1997) Comparison of functional results after ethmoidectomy and nasalization for diffuse and severe nasal polyposis. Acta Otolaryngol 117:601–608CrossRefGoogle Scholar
  11. 11.
    Jankowski R, Pigret D, Decroocq F et al (2006) Comparison of radical (nasalisation) and functional ethmoidectomy in patients with severe sinonasal polyposis. A retrospective study. Rev LaryngolOtolRhinol (Bord) 127:131–140Google Scholar
  12. 12.
    Videler WJ, Wreesmann VB, van derMeulen FW et al (2006) Repetitive endoscopic sinus surgery failure: a role for radical surgery? Otolaryngol Head Neck Surg 134:586–591CrossRefGoogle Scholar
  13. 13.
    Anastasopoulos G, Grigoriadis G, Papoutsi S (2013) Modified nasal dermoplasty technique for treatment of recurrent polyposis: preliminary results. J Laryngol Otol 127:595–598CrossRefGoogle Scholar
  14. 14.
    Johansson L, Akerlund A, Holmberg K et al (2000) Evaluation of methods for endoscopic staging of nasal polyposis. Acta Otolaryngol 120:72–76CrossRefGoogle Scholar
  15. 15.
    Lund VJ, Kennedy DW (1997) Staging for rhinosinusitis. Otolaryngol Head Neck Surg 117:S35–S40CrossRefGoogle Scholar
  16. 16.
    Browne JP, Hopkins C, Slack R et al (2007) The sino-nasal outcome test (SNOT): can we make it more clinically meaningful? Otolaryngol Head Neck Surg 136:736–741CrossRefGoogle Scholar
  17. 17.
    Anastasopoulos G, Vicheva D, Tsiompanou E et al (2016) The technique of dermoplasty to treat recurrent nasal polyps: preoperative evaluation, surgical details, postoperative endoscopic appearance and histopathologic analysis. Rom J Rhinol 6:203–206Google Scholar
  18. 18.
    DeConde AS, Suh JD, Mace JC et al (2015) Outcomes of complete vs targeted approaches to endoscopic sinus surgery. Int Forum Allergy Rhinol 5:691–700CrossRefGoogle Scholar
  19. 19.
    Danielsen A, Olofsson J (1996) Endoscopic endonasal sinus surgery. A long-term follow-up study. Acta Otolaryngol 116:611–619CrossRefGoogle Scholar
  20. 20.
    Wynn R, Har-El G (2004) Recurrence rates after endoscopic sinus surgery for massive sinus polyposis. Laryngoscope 114:811–813CrossRefGoogle Scholar
  21. 21.
    Dalziel K, Stein K, Round A et al (2006) Endoscopic sinus surgery for the excision of nasal polyps: a systematic review of safety and effectiveness. Am J Rhinol 20:506–519CrossRefGoogle Scholar
  22. 22.
    Mendelsohn D, Jeremic G, Wright ED et al (2011) Revision rates after endoscopic sinus surgery: a recurrence analysis. Ann OtolRhinolLaryngol 120:162–166Google Scholar
  23. 23.
    Noon E, Hopkins C (2016) Review article: outcomes in endoscopic sinus surgery. BMC Ear Nose Throat Disord 16:9CrossRefGoogle Scholar
  24. 24.
    Jafari A, DeConde AS (2016) Outcomes in medical and surgical treatment of nasal polyps. AdvOtorhinolaryngol 79:158–167Google Scholar
  25. 25.
    Kennedy JL, Hubbard MA, Huyett P et al (2013) Sino-nasal outcome test (SNOT-22): a predictor of postsurgical improvement in patients with chronic sinusitis. Ann Allergy Asthma Immunol 111:246–251CrossRefGoogle Scholar
  26. 26.
    DeConde AS, Mace JC, Bodner T, Hwang PH et al (2014) SNOT-22 quality of life domains differentially predict treatment modality selection in chronic rhinosinusitis. Int Forum Allergy Rhinol 4:972–979CrossRefGoogle Scholar
  27. 27.
    Andrews PJ, Poirrier AL, Lund VJ et al (2016) Outcomes in endoscopic sinus surgery: olfaction, nose scale and quality of life in a prospective cohort study. ClinOtolaryngol 41:798–803Google Scholar

Copyright information

© Association of Otolaryngologists of India 2018

Authors and Affiliations

  1. 1.Department of OtolaryngologyVougiouklakeio HospitalAthensGreece
  2. 2.Eugenidion HospitalNational University of AthensAthensGreece

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