Postoperative Polyp Scale (POPS): Development of a New Sinonasal Polyp Grading Scale

Arthur W Wu; Akaber M Halawi; Elisa A Illing; Dennis M Tang; Philip G Chen; Edward C Kuan; Jonathan Y Ting; Daniel A Norez; Stacey A Kim; Dhruv Sharma; Douglas D Reh; Sanjeet V Rangarajan; Kent K Lam; Randall A Ow; J Wesley Sublett; Thomas S Higgins

doi:10.1002/lary.30623

Postoperative Polyp Scale (POPS): Development of a New Sinonasal Polyp Grading Scale

Laryngoscope. 2023 Nov;133(11):2885-2890. doi: 10.1002/lary.30623. Epub 2023 Mar 3.

Authors

Arthur W Wu^{1

2}, Akaber M Halawi^{1

3}, Elisa A Illing^{1

4}, Dennis M Tang^{1

2}, Philip G Chen^{1

5}, Edward C Kuan^{1

6}, Jonathan Y Ting^{1

4}, Daniel A Norez⁷, Stacey A Kim⁸, Dhruv Sharma^{1

4}, Douglas D Reh^{1

9}, Sanjeet V Rangarajan^{1

10}, Kent K Lam^{1

11}, Randall A Ow^{1

12}, J Wesley Sublett^{1

13}, Thomas S Higgins^{1

14

15}

Affiliations

¹ Snot Force Alliance, Inc., Louisville, Kentucky, USA.
² Division of Otolaryngology-Head and Neck Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.
³ Division of Otolaryngology-Head and Neck Surgery, University of Florida Health College of Medicine Jacksonville, Jacksonville, Florida, USA.
⁴ Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA.
⁵ Department of Otolaryngology-Head and Neck Surgery, University of Texas Health San Antonio, San Antonio, Texas, USA.
⁶ Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, Orange, California, USA.
⁷ College of Medicine-Jacksonville, Center for Data Solutions, University of Florida, Gainesville, Florida, USA.
⁸ Department of Pathology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
⁹ Department of Otolaryngology-Head and Neck Surgery, Greater Baltimore Medical Center, Baltimore, Maryland, USA.
¹⁰ Department of Otolaryngology-Head and Neck Surgery, University of Tennessee, Memphis, Tennessee, USA.
¹¹ Department of Otolaryngology-Head and Neck Surgery, Eastern Virginia Medical School, Norfolk, Virginia, USA.
¹² Sacramento Ear, Nose, and Throat, Sacramento, California, USA.
¹³ Family Allergy & Asthma, Louisville, Kentucky, USA.
¹⁴ Department of Otolaryngology-Head and Neck Surgery, University of Louisville, Louisville, Kentucky, USA.
¹⁵ Rhinology, Sinus & Skull Base, Kentuckiana ENT, a Division of ENT Care Centers, Louisville, Kentucky, USA.

PMID: 36866689
DOI: 10.1002/lary.30623

Abstract

Objective: Commonly used endoscopic grading scales, such as the nasal polyp scale, inadequately describe the degree of polyposis found postoperatively in the paranasal sinus cavities. The purpose of this study was to create a novel grading system that more accurately characterizes polyp recurrence in postoperative sinus cavities, the Postoperative Polyp Scale (POPS).

Methods: A modified Delphi method was utilized to establish the POPS using consensus opinion among 13 general otolaryngologists, rhinologists, and allergists. Postoperative endoscopy videos from 50 patients with chronic rhinosinusitis with nasal polyps were reviewed by 7 fellowship-trained rhinologists and scored according to the POPS. Videos were rated again 1 month later by the same reviewers, and scores were assessed for test-retest and inter-rater reliability.

Results: Overall inter-rater reliability for the first and second reviews of the 52 videos was Kf = 0.49 (95% CI 0.42-0.57) and Kf = 0.50 (95% CI 0.42-0.57) for the POPS. Intra-rater reliability showed near-perfect test-retest reliability for the POPS with Kf = 0.80 (95% CI 0.76-0.84).

Conclusion: The POPS is an easy-to-use, reliable, and novel objective endoscopic grading scale that more accurately describes polyp recurrence in the postoperative state which will be useful in the future for measuring the efficacy of various medical and surgical interventions.

Level of evidence: 5 Laryngoscope, 133:2885-2890, 2023.

Keywords: chronic rhinosinusitis; endoscopic grading; endoscopic sinus surgery; nasal polyps; outcomes.

MeSH terms

Chronic Disease
Endoscopy / methods
Humans
Nasal Polyps* / diagnosis
Nasal Polyps* / surgery
Paranasal Sinuses* / surgery
Reproducibility of Results
Rhinitis* / diagnosis
Rhinitis* / surgery
Sinusitis* / diagnosis
Sinusitis* / surgery