The submitted paper presents an analysis of anamnestic data and results of individual examinations in a group of patients with nasal polyposis, followed up on a long-term basis. The analysis was focused on the identification of risk factors which influence the therapeutic results. The data were evaluatedin 246 patients of the ENT Clinic and included 100 women and 146 men, mean age 46.1 years (44.5 years in men and 48.3 years in women) with a range from 17 to 78 years. It is a retrospective study. In the group all patients were included with nasal polyposis treated at the ENT Clinic during the investigation period from October 1989 to December 1994 with complete health records. These patients were followed up for a minimum period of three years after surgery at the ENT out-patient department of the Clinic. Surgery was the main therapeutic method. Nasal polyps were in the majority removed by the method based on principles of functional endoscopic sinus surgery by Messerklinger’s technique. From the group patients with typical antrochoanal polyps were eliminated. The effect of treatment was evaluated with regard to the following factors - age, sex, age when first complaints developed, length of the case-history, previous surgical treatment, concurrent presence of allergy, presence of bronchial asthma, aspirin intolerance, inflammations of the paranasal sinuses, extent of affection of the nasal cavity and extent of affection of the paranasal sinuses. The therapeutic results were evaluated with regard to the persistence or reappearance of subjective complaints of the patient and the objective rhinoscopic finding of recurrence of nasal polyps. The relations between the investigated parameters were calculated by correlation coefficients accor- ding to statistical analysis, using the Excell programme. The mean age of patients in the group with a relapse of complaints within three years after surgery was 50.5 years. The sex ratio was approximately equal. No correlation was found between age and the period without complaints (correlation coefficient 0.03). The mean age at the time of the initial complaints was 38.6 years with the highest frequency between the age of 30 and 50 years (121 patients, i. e. 49.2%), and with an equal sex distribution. A relapse of complaints developed in patients where the first complaints developed before the age of 30 (71 patients) occurred in 26.7%. The mean period of the history was 4.9 years. There was no marked correlation between the length of the history and the extent of affection of the nasal cavity (correlation coefficient 0.043), 132 patients, i. e. 55.2% of the group were subjected to some type of surgery of the nasal cavity or paranasal sinuses. Among the types of surgery polypectomy predominated (113 patients, i. e. 45%) and surgery of the maxillary sinuses according to Caldwell-Luca (26 patients, i. e. 10.6%). The mean interval between individual polypectomies was 4.2 years. This interval declines with the increasing number of operations. A relapse of complaints occurred in the group of patients after repeated polypectomies in 28.5%. Various forms of allergic reactions incl. allergic reactions to drugs were recorded in 113 patients, i. e. 45.9% with a slightly higher proportion of women (65 patients, i. e. 57.5%). In this group of patients 31% developed relapses. Bronchial asthma was present in 54 patients, i. e. 21.9% without predilection of sex. Among patients with bronchial asthma relapses occurred in 25.9%. Aspirin intolerance was recorded in 24 patients, i. e. 9.7%, more frequently in women (18 patients i. e. 75%). A relapse of complaints occurred in 66.7% patients with aspirin intolerance. Sinusitis in the case-history was reported by 41 patients, i. e. 16.7%, both sexes being represented equally. In the group of patients with a history of inflammations of the paranasal sinuses relapses of complaints were recorded in 39%. The mean score expressing the extent of affection of the nasal cavity was 3.3. No correlation was found between the extent of affection of the nasal cavity and the length of the history (correlation coefficient 0.032) or with age at the time of the first complaints (correlation coefficient 0.026). With the extent of affection of the paranasal cavity increases also the extent of affection of the paranasal sinuses (correlation coefficient 0.54). The mean score expressing the extent of affection of the paranasal sinuses 13.1. No correlation was found between the extent of affection and the length of the history (correlation coefficient 0.043) nor with age at the time of the first complaints (correlation coefficient 0.094). The results of analyses in the investigated group of patients with nasal polyposis revealed the necessity to differentiate heterogeneous groups of patients. Evaluation of therapeutic results in patients suffering from nasal polyposis as a whole can lead to deceptive conclusions. The highest risk factors as regards early relapse are in the authors’ opinion the presence of aspirin intolerance and concurrent inflammations of the paranasal sinuses. If one of these two factors is detected, long-term follow up and permanent conservative treatment is a necessity.

        Key words: nasal polyposis, risk factors, surgical treatment, aspirin intolerance.