Lund-Mackay Score is Predictive of Bleeding in Ethmoidectomy for Nasal Polyposis

Objectives: To assess the correlation between intraoperative bleeding during endoscopic ethmoidectomy for chronic rhinosinusitis with nasal polyps and objective parameters of disease severity.

Study Design: A prospective cohort of 40 patients with nasal polyposis treated by endoscopic ethmoidectomy was analyzed from January 2007 to July 2007.

Methods: Polyp size and CT scan opacifications were noted. The surgical procedure was performed with a standardized protocol. Intraoperative blood loss was measured. The Spearman test was used to correlate these data.

Results: On nasal endoscopy, the mean polyps' size score was 2.2 (+/- 0.65). On CT scan, the Lund-Mackay grading was 17.2/24 (+/- 5.8). The rate of flow of intraoperative bleeding was 0.077%/min (+/- 0.070%/min). A significant positive correlation was found between the CT scan score and the rate of flow of intraoperative bleeding for the patients who were surgically treated for the first time (n = 23, Spearman Rho = 0.411, p = 0.05).

Conclusion: The Lund-Mackay CT score is useful in predicting intraoperative bleeding during endoscopic ethmoidectomy. It could help to identify patients for whom specific measures like preoperative treatment with antibiotics and steroids, topical perioperative preparation of the nose or hypotensive anesthesia are required in order to reduce the risk of intraoperative complications.