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Abstract：
Introduction Despite the high level of patient satisfaction with functional endoscopic sinus surgery (FESS) and the clinical improvement, polyp recurrence is observed in 23% to 87% of patients and requires reoperation. Objective To assess the prognostic value of polypoid changes of the middle turbinate (PCMT) in relapse of paranasal sinus polyps in patients with chronic rhinosinusitis with nasal polyp (CRSwNP) after FESS and the effect of partial middle turbinectomy (PMT) on the outcome of surgery. Methods We conducted a prospective clinical study on 60 patients with CRSwNP with and without PCMT. The patients were allocated into three groups: group I included twenty patients without PCMT; group II, twenty patients with PCMT; and group III included twenty patients with PCMT submitted to PMT. The patients were evaluated endoscopically according to the Lund-Kennedy endoscopic scoring system, radiologically according to the Lund-Mackay scoring system, and symptomatically through the 22-item Sinonasal Outcome Test (SNOT-22). Results The total postoperative Lund-Kennedy score differed significantly among the 3 groups ( p < 0.001), with a group II presenting a significantly higher total score compared to groups I and III. The Preoperative SNOT-22 score differed significantly among the three groups ( p = 0.013), with group II presenting a significantly higher score compared to group I. There was a significant association involving the 3 groups and relapse at 12 months ( p = 0.029); relapse was higher in group II (50.0%) than in groups I (20%) and III (15.0%). Conclusion There was a significant association between PCMT and the relapse of nasal polyps. Also, nasal polyposis recurred at a lower rate in the group submitted to middle turbinate resection compared to the group in whom it was preserved.
摘要：
简介尽管患者对功能性内窥镜鼻窦手术（FESS）的满意度很高，并且临床上有所改善，23％至87％的患者观察到息肉复发，需要再次手术。目的探讨中鼻甲息肉样改变(PCMT)对慢性鼻-鼻窦炎伴鼻息肉(CRSwNP)术后鼻窦息肉复发的预测价值及部分中鼻甲切除术(PMT)对手术效果的影响.方法我们对60例伴或不伴PCMT的CRSwNP患者进行了前瞻性临床研究。将患者分为三组：第一组包括20例未使用PCMT的患者；第二组，20例PCMT患者;第三组包括20例接受PMT治疗的PCMT患者。根据Lund-Kennedy内镜评分系统对患者进行内镜评估，根据隆德-麦凯评分系统的放射学，并通过22项鼻窦结果测试（SNOT-22）对症。结果3组术后Lund-Kennedy总评分差异有统计学意义(p<0.001),与I组和III组相比，II组的总分明显更高。术前SNOT-22评分在三组间有显著差异(p=0.013),与第I组相比，第II组的评分明显更高。3组之间存在显着相关性，并且在12个月时复发（p=0.029）；第II组（50.0％）的复发率高于第I组（20％）和第III组（15.0％）。结论PCMT与鼻息肉的复发有显著相关性。此外，与保留鼻息肉的组相比，接受中鼻甲切除术的组鼻息肉的复发率较低。
