A Novel Technique for the Treatment of Intractable Nasal Polyposis: Surgical Highlights of the Dermoplasty Technique

At least three medical specialties are occupied, among other things of course, with the treatment of nasal polyps: Pulmonology, allergology, and certainly the otolaryngologists. This is because the nose plays an important role in the physiology of the respiratory system and it directly affects the quality of life. Also, nasal polyps are detected in a significant up to 4% portion of the adult population [1] and despite their benign nature, may present a recurrence rate of up to 60% [2]. Various techniques have been proposed for the surgical treatment of nasal polyps through time. Simple polypectomy is still in use from the era of Hippocrates using various instruments under local or general anesthesia. The introduction of endoscopes in nasal surgery in the ‘80s had a major impact in the treatment of chronic rhinosinusitis. Still a 20% of revision surgery within five years is reported. Other major operations such as the complete removal of the floor of the frontal sinuses have been proposed but with similar results. In this setting we designed a new method for severe polyposis based not on the extent of surgical extirpation, which would lead to other equally serious complications such as atrophic rhinitis and empty nose syndrome [3], but rather on the replacement of the diseased mucosa of the middle meatus which is mainly responsible for the eruption of polyps. The concept of replacing diseased mucosa with skin graft is old and well tested but the use of dermoplasty for the treatment of nasal polyposis was announced for the first time [4]. Materials and Method