N 5 (196) 2025. P. 20–25

EVALUATION OF RISK FACTORS FOR INTRAOPERATIVE BLEEDING IN ENDOSCOPIC SURGERY IN PATIENTS WITH CHRONIC RHINOSINUSITIS WITH NASAL POLYPS AND ASPIRIN-EXACERBATED RESPIRATORY DISEASE

I. A. Moldovanov, D. D. Zabolotna

State Institution “O. S. Kolomiychenko Institute of Otolaryngology of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine

DOI 10.32782/2226-2008-2025-5-3

Background. Chronic rhinosinusitis with nasal polyps (CRSwNP) is a common inflammatory disease of the paranasal sinuses that significantly impacts the quality of life. Functional endoscopic sinus surgery is the standard surgical method; however, intraoperative bleeding is a clinically significant issue, especially in patients with aspirin-exacerbated respiratory disease (AERD).

Objective. To assess factors associated with increased intraoperative bleeding in patients with CRSwNP and AERD and compare the extent of intraoperative bleeding between AERD and non-AERD groups.

Methods. A retrospective analysis was conducted on 40 patients who underwent endoscopic endonasal pansinusotomy (EEP): 27 with AERD and 13 without AERD. Assessed parameters included intraoperative blood loss (mL), surgical field visualization (Boezaart scale), and disease severity (modified Lund–Mackay scale). Statistical analysis involved Student’s t-test and Pearson’s correlation coefficient (p < 0.05). Results. Patients with AERD had significantly higher intraoperative blood loss (161.9 ± 39.5 mL vs. 108.5 ± 45.0 mL, p = 0.001) and poorer surgical field visibility (Boezaart score: 3.26 ± 0.7 vs. 2.54 ± 0.7, p = 0.009) compared to non-AERD patients. The modified Lund–Mackay score was also higher in AERD patients (36.07 ± 10.5 vs. 27.69 ± 9.9, p = 0.021), indicating an association with increased

intraoperative bleeding.

Conclusion. Patients with AERD have increased intraoperative bleeding and reduced surgical field visibility. The modified Lund–Mackay score may help predict bleeding risk, highlighting the need for individualized preoperative strategies to minimize surgical complications.

Keywords: sinusitis, nasal polyps, aspirin-exacerbated respiratory disease, endoscopy, bleeding.

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