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随着时间的推移和图像指导的采用,内镜鼻手术并发症率是否在改善?

Katherine Lauritsen, Arman Saeedi, Vijay R Ramakrishnan

medRxiv : the preprint server for health sciences

|November 24, 2025

概括

内镜外科手术 (ESS) 的并发症仍然很低,但表症的发生率正在增加. 术内导航系统 (IGS) 的使用与减少CSF泄漏风险,但较高的表症率有关.

科学领域:

耳鼻喉科耳鼻喉科耳鼻喉科
手术创新在外科创新.
患者安全患者安全

背景情况:

透视鼻手术 (ESS) 是慢性鼻炎 (CRS) 的常见治疗方法.
在文献和患者咨询中经常引用ESS的确定的并发症率.
手术技术和技术的进步可能会影响现代并发症率.

研究的目的:

评估ESS之后的当代并发症率.
评估随着时间的推移并发症和手术内导航系统 (IGS) 使用的趋势.
为了比较不同年龄组的并发症率.

主要方法:

对TriNetX研究网络 (2010-2023) 进行了回顾性分析.
数据包括ESS并发症,如CSF泄漏,轨道损伤和表.
在两个时间段 (2010-2016 vs. 2017-2023) 和年龄组 (儿科,青少年,成人) 中分析了并发症率和IGS趋势.

主要成果:

与之前的报告相比,主要并发症 (CSF泄漏,轨道损伤) 的发生率相似或有所改善.
经外和其他外科手术后并发症超过1%,表明需要注意.
随着时间的推移,IGS的使用增加了,并且与较低的CSF泄漏率 (0.8%与0.95%) 相关,但较高的表率 (2.5%与2.1%).
在18岁以下的患者中,CSF泄漏率更高,而成年人则出现更高的脑膜外率.

结论:

虽然ESS并发症仍然很低,但日益增加的表症率需要注意.
术后并发症的增加可能与人口健康状况恶化有关.
使用IGS与CSF泄漏的风险降低有关.

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