The patient had undergone endoscopic nasal polypectomy in an outside hospital for 3 months and went to the local hospital first because of the recurrence of nasal congestion after a cold. The patient came to our outpatient clinic with questions. After anterior rhinoscopy, the patient had a large amount of purulent nasal discharge and the structure of the middle nasal passage was unclear, so the patient was advised to undergo nasal endoscopy. The nasal endoscopy showed: adhesions between the middle turbinate and the lateral wall of the nasal cavity, a large number of vesicles in the middle nasal passage, and mucosal edema at the sinus opening. I asked the patient, “Have you reviewed your nasal polyps after surgery?” The patient said, “I only reviewed it once after the operation, and I did not review it again because the symptoms improved.” Since the patient had a cold and was in the acute inflammatory stage, I suggested the patient to take oral antibiotics and hormone treatment for one week and then review again in the clinic.
One week later, the patient came to my clinic again and the nasal endoscopy showed that the purulent nasal discharge was greatly reduced and there were adhesions in the middle turbinate. The patient was reviewed in half a month. Before the review, he was treated with topical hormonal nasal spray and local nasal wash. Half a month later, the patient’s nasal congestion was significantly relieved and no obvious purulent discharge was seen in the nasal cavity. After 3-5 times of such outpatient nasal endoscopic drug changes, the patient’s middle nasal tract mucosa was epithelialized and the sinus opening was good after 3 months. No recurrence of nasal polyps was observed at six months follow-up.
Since nasal endoscopic surgery has become popular, the recurrence rate of nasal polyps has been greatly reduced, but the 5-year recurrence rate is still as high as 20%, so standardized, systematic and personalized treatment is an effective way to reduce the recurrence of nasal polyps. Postoperative follow-up is a key step in standardized treatment. The standardized treatment includes preoperative, intraoperative and postoperative stages, but the patient only paid attention to the intraoperative treatment stage, but ignored the importance of postoperative follow-up, so the nasal symptoms recurred only three months after surgery. The recommendation of the patient to operate again in the local hospital was also inadequate, because the patient’s first operation had opened the sinuses, and clinical cure could be achieved by local drug exchange and drug systemic treatment, so the patient should not be rashly treated by surgery again.