METHODS: Patients diagnosed with SNM were prospectively enrolled in a multi-center patient registry. SNOT-22 scores were collected at the time of diagnosis and through the post-treatment period for up to 5 years. Multivariable regression analysis was used to identify drivers of variation in SNOT-22 subdomains.
RESULTS: Note that 234 patients were reviewed, with a mean follow-up of 22 months (3 months-64 months). Rhinologic, psychological, and sleep subdomains significantly improved versus baseline (all p < 0.05). Subanalysis of 40 patients with follow-up at all timepoints showed statistically significant improvement in rhinologic, extra-nasal, psychological, and sleep subdomains, with minimal clinically important difference met between 2 and 5 years in sleep and psychological subdomains. Adjuvant chemoradiation was associated with worse outcomes in rhinologic (adjusted odds ratio (5.22 [1.69-8.66])), extra-nasal (2.21 [0.22-4.17]) and ear/facial (5.53 [2.10-8.91]) subdomains. Pterygopalatine fossa involvement was associated with worse outcomes in rhinologic (3.22 [0.54-5.93]) and ear/facial (2.97 [0.32-5.65]) subdomains. Positive margins (5.74 [2.17-9.29]) and surgical approach-combined versus endoscopic (3.41 [0.78-6.05])-were associated with worse psychological outcomes. Adjuvant radiation (2.28 [0.18-4.40]) was associated with worse sleep outcomes.
CONCLUSIONS: Sinonasal QOL improvements associated with treatment of SNM are driven by rhinologic, extra-nasal, psychological, and sleep subdomains.
方法:将诊断为SNM的患者前瞻性纳入多中心患者登记。在诊断时和治疗后的长达5年的时间内收集SNOT-22评分。多变量回归分析用于确定SNOT-22子域变异的驱动因素。
结果:请注意,对234例患者进行了回顾,平均随访22个月(3个月-64个月)。鼻科,心理,与基线相比,睡眠亚域显着改善(所有p<0.05)。在所有时间点进行随访的40例患者的亚分析显示,鼻科有统计学意义的改善,鼻外,心理,和睡眠子域,在睡眠和心理亚域中,2至5年之间的临床重要差异最小。辅助放化疗与鼻科预后较差相关(校正比值比(5.22[1.69-8.66])),鼻外(2.21[0.22-4.17])和耳/面部(5.53[2.10-8.91])亚结构域。翼腭窝受累与鼻(3.22[0.54-5.93])和耳/面部(2.97[0.32-5.65])子域的不良预后相关。阳性切缘(5.74[2.17-9.29])和联合手术方法与内镜(3.41[0.78-6.05])与较差的心理结局相关。辅助辐射(2.28[0.18-4.40])与较差的睡眠结果相关。
结论:与SNM治疗相关的鼻窦QOL改善是由鼻窦,鼻外,心理,和睡眠子域。