扩大的额头鼻腔切除术和带鼻息肉的慢性鼻炎:控制疾病的有效策略
Tommaso Saccardo1,2, Valentine Nicolas2, Emilien Chebib3
1Department of Neuroscience DNS, Otolaryngology Section, University of Padova, Padova, Italy.
The Annals of otology, rhinology, and laryngology
|November 12, 2024
概括
扩大的额头鼻腔切除术 (EFS) 显著改善生活质量,并减少严重的慢性鼻炎与鼻息肉 (CRSwNP) 患者的系统性皮质类固醇使用. 这种手术方法提供了一个持久有效的治疗选择,并发症最小.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 鼻科 鼻科是指鼻科的专家.
- 手术创新 在外科创新.
背景情况:
- 具有鼻息肉的慢性鼻炎 (CRSwNP) 显著损害了患者的生活质量 (QoL).
- 目前的治疗包括鼻腔内和全身性皮质类固醇 (SCS),对于耐火病例,建议进行手术.
- 严重的CRSwNP通常需要先进的外科干预.
研究的目的:
- 评估扩大的额头鼻腔切除术 (EFS),特别是Draf IIb或Draf III手术对QOL的影响.
- 评估EFS后每年全身性皮质类固醇 (SCS) 消费量的减少.
- 确定EFS在严重CRSwNP患者的长期疗效和安全性.
主要方法:
- 在2006年至2020年期间,对38名患有严重CRSwNP的患者进行了EFS (IIb或III草案) 的回顾性队列研究.
- 使用手术前和手术后的SNOT-22问卷来评估生活质量.
- 在手术前和手术后记录了每年SCS治疗频率.
主要成果:
- EFS程序导致SNOT-22得分显著改善 (平均下降为-32.7,P < 0.001).
- 年度SCS治疗显著下降,从平均4.8降至0.6 (P<0.001).
- 95%的患者在平均88个月的随访期间实现了令人满意的疾病控制,修订率低.
结论:
- 扩大的额头鼻腔切除术 (EFS) 是严重CRSwNP的有效治疗选择.
- EFS显著提高了患者的QOL,并大大减少了对全身皮质类固醇的需求.
- 该程序证明了持久的疾病控制,具有有利的安全性.
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