■使用局部皮质类固醇治疗内窥镜颅底手术(ESBS)后的鼻窦症状尚未得到很好的研究。我们量化了术后类固醇灌溉(SI)对ESBS患者生活质量的长期影响。
■2010年至2019年在宾夕法尼亚大学接受ESBS的患者的回顾性审查。收集患者人口统计学和术后治疗数据,每天两次使用或不使用溶解的类固醇(莫米松或布地奈德)进行鼻腔盐水冲洗。术前,1-,3-,6-,12-,18-,并对术后24个月鼻塞结局测试(SNOT-22)评分进行评估。
■共评估了727例患者(53.4%为男性),无SI组479例,SI组248例。术前SNOT-22评分差异无统计学意义(P=0.19)。1-,3-,6-,12-,18-,术后24个月的SNOT-22评分在组间无显著差异.然而,与布地奈德(P<0.01)和生理盐水(P=0.03)相比,莫米松灌洗导致术后2年SNOT-22评分显著降低.
■尽管皮质类固醇灌溉是治疗炎症性鼻窦疾病的常规方法,它们在肿瘤ESBS术后管理中的作用尚不清楚.我们的发现表明,莫米松冲洗可能有效改善ESBS术后患者的生活质量。
UNASSIGNED: The use of topical corticosteroids to manage postoperative sinonasal symptoms after endoscopic skull base surgery (ESBS) has not been well studied. We quantified long-term impact of postoperative steroid irrigations (SIs) on quality of life of patients after ESBS.
UNASSIGNED: Retrospective review of patients at the University of Pennsylvania undergoing ESBS from 2010 to 2019. Data on patient demographics and postoperative treatment with nasal saline irrigation twice daily with and without dissolved steroids (mometasone or budesonide) was collected. Preoperative, and 1-, 3-, 6-, 12-, 18-, and 24-month postoperative Sino-Nasal Outcome Test (SNOT-22) scores were assessed.
UNASSIGNED: A total of 727 patients were assessed (53.4% males), with 479 patients in the no SI group and 248 patients in the SI group. Preoperative SNOT-22 scores did not differ significantly (P = 0.19). 1-, 3-, 6-, 12-, 18-, and 24-month post-op SNOT-22 scores did not significantly differ between groups. However, mometasone irrigations resulted in significantly lower postoperative 2-year SNOT-22 scores compared to budesonide (P < 0.01) and saline (P = 0.03).
UNASSIGNED: Though corticosteroid irrigations are routine in managing inflammatory sinus disease, their role in postoperative management after ESBS for tumors is unclear. Our findings suggest that mometasone irrigation may be effective at improving postoperative quality of life in patients after ESBS.