Abstract：
BACKGROUND: Headache and facial pain are common symptoms of chronic rhinosinusitis (CRS). However, given the numerous etiologies that can cause these symptoms, the impact of sinus surgery is not well characterized.
METHODS: A systematic review was performed by searching the literature from inception through June 6, 2023. English-language articles reporting outcomes for facial pain/pressure or headache following endoscopic sinus surgery were selected for inclusion. Meta-analyses were performed using random and fixed effect models on continuous measures (mean), mean difference (Δ), and proportions (%).
RESULTS: A total of 26 articles reporting on 2839 patients were selected for inclusion. The mean patient age was 44.0 ± 3.9 (range 16.0-84.0), with an average symptom duration of 5.3 ± 2.8 years. Among these patients, 56.5% (95% confidence interval [CI]: 52.3-60.6) were male and 77.0% (95% CI: 56.6-92.3) had nasal polyposis (NP). Patients with and without NP reported substantial reductions in both 22-item sino-nasal outcome test facial pain/pressure (with NP: -1.4 [95% CI: -1.6 to -1.2; relative reduction 59.1%]; without NP: -1.5 [95% CI: -1.9 to -1.1; relative reduction 60.9%]) and visual analogue scale (VAS) headache (with NP: -2.5 [95% CI: -2.8 to -2.1; relative reduction 67.2%]; without NP: -2.8 [95% CI: -4.7 to -1.0; relative reduction 42.7%]). Symptom reductions were greater in the without NP versus with NP group; VAS facial pain/pressure: Δ0.4 (95% CI: 0.2-0.6; p = 0.0006) and VAS headache: Δ0.4 (95% CI: 0.1-0.7; p = 0.02).
CONCLUSIONS: Our findings suggest that CRS patients, regardless of polyp status, benefit from significant reductions in facial pain/pressure and headache following surgical therapy.
METHODS: A systematic review was performed by searching the literature from inception through June 6, 2023. English-language articles reporting outcomes for facial pain/pressure or headache following endoscopic sinus surgery were selected for inclusion. Meta-analyses were performed using random and fixed effect models on continuous measures (mean), mean difference (Δ), and proportions (%).
RESULTS: A total of 26 articles reporting on 2839 patients were selected for inclusion. The mean patient age was 44.0 ± 3.9 (range 16.0-84.0), with an average symptom duration of 5.3 ± 2.8 years. Among these patients, 56.5% (95% confidence interval [CI]: 52.3-60.6) were male and 77.0% (95% CI: 56.6-92.3) had nasal polyposis (NP). Patients with and without NP reported substantial reductions in both 22-item sino-nasal outcome test facial pain/pressure (with NP: -1.4 [95% CI: -1.6 to -1.2; relative reduction 59.1%]; without NP: -1.5 [95% CI: -1.9 to -1.1; relative reduction 60.9%]) and visual analogue scale (VAS) headache (with NP: -2.5 [95% CI: -2.8 to -2.1; relative reduction 67.2%]; without NP: -2.8 [95% CI: -4.7 to -1.0; relative reduction 42.7%]). Symptom reductions were greater in the without NP versus with NP group; VAS facial pain/pressure: Δ0.4 (95% CI: 0.2-0.6; p = 0.0006) and VAS headache: Δ0.4 (95% CI: 0.1-0.7; p = 0.02).
CONCLUSIONS: Our findings suggest that CRS patients, regardless of polyp status, benefit from significant reductions in facial pain/pressure and headache following surgical therapy.
摘要：
背景：头痛和面部疼痛是慢性鼻-鼻窦炎（CRS）的常见症状。然而,考虑到可以导致这些症状的多种病因，鼻窦手术的影响没有得到很好的表征。
方法：通过检索从开始到2023年6月6日的文献进行了系统评价。选择了报告内窥镜鼻窦手术后面部疼痛/压力或头痛结果的英文文章。使用随机和固定效应模型对连续测量(平均值)进行荟萃分析，平均差(Δ)，比例（%）。
结果：共选择26篇报告2839例患者的文章纳入。患者平均年龄为44.0±3.9（范围16.0-84.0），平均症状持续时间为5.3±2.8年。在这些患者中,男性占56.5％（95％置信区间[CI]：52.3-60.6），鼻息肉病（NP）占77.0％（95％CI：56.6-92.3）。有和没有NP的患者报告了22项鼻鼻部结局测试面部疼痛/压力的显着减少（NP：-1.4[95％CI：-1.6至-1.2；相对减少59.1％]；没有NP：-1.5[95％CI：-1.9至-1.1；相对减少60.9％]）和视觉模拟评分（VAS）头痛（NP：-2.5；95％CI：-2.8-2.1；相对减少67.2％：相对减少与NP组相比，无NP组的症状减轻更大；VAS面部疼痛/压力：Δ0.4（95％CI：0.2-0.6；p=0.0006）和VAS头痛：Δ0.4（95％CI：0.1-0.7；p=0.02）。
结论：我们的研究结果表明，CRS患者，不管息肉状况如何,受益于手术治疗后面部疼痛/压力和头痛的显着减少。
方法：通过检索从开始到2023年6月6日的文献进行了系统评价。选择了报告内窥镜鼻窦手术后面部疼痛/压力或头痛结果的英文文章。使用随机和固定效应模型对连续测量(平均值)进行荟萃分析，平均差(Δ)，比例（%）。
结果：共选择26篇报告2839例患者的文章纳入。患者平均年龄为44.0±3.9（范围16.0-84.0），平均症状持续时间为5.3±2.8年。在这些患者中,男性占56.5％（95％置信区间[CI]：52.3-60.6），鼻息肉病（NP）占77.0％（95％CI：56.6-92.3）。有和没有NP的患者报告了22项鼻鼻部结局测试面部疼痛/压力的显着减少（NP：-1.4[95％CI：-1.6至-1.2；相对减少59.1％]；没有NP：-1.5[95％CI：-1.9至-1.1；相对减少60.9％]）和视觉模拟评分（VAS）头痛（NP：-2.5；95％CI：-2.8-2.1；相对减少67.2％：相对减少与NP组相比，无NP组的症状减轻更大；VAS面部疼痛/压力：Δ0.4（95％CI：0.2-0.6；p=0.0006）和VAS头痛：Δ0.4（95％CI：0.1-0.7；p=0.02）。
结论：我们的研究结果表明，CRS患者，不管息肉状况如何,受益于手术治疗后面部疼痛/压力和头痛的显着减少。
