■内窥镜鼻窦手术(ESS)已成为治疗药物治疗难治性慢性鼻-鼻窦炎(CRS)患者的金标准。它被认为是所有年龄组的相对安全和有效的程序,总体成功率从76%到97.5%不等。然而,原发性内窥镜鼻窦手术(PESS)的失败发生率为2%至24%。PESS和最佳药物治疗后仍有症状的患者是修正内窥镜鼻窦手术(RESS)的候选人。
■研究ESS的转归,评估鼻息肉复发的危险因素,以及比较PESS和RESS在三级护理教学医院的结果。
■回顾性横断面研究。
■这项研究是针对2015年5月至2021年12月在沙特国王大学医学城(KSUMC)接受ESS治疗的CRS鼻息肉(CRSwNP)患者进行的。在此期间,对于CRSwNP进行ESS470次。鼻窦结果测试22(SNOT-22)问卷,Lund-Kennedy(LK)得分,隆德-麦凯(LM)得分,息肉分级系统用于评估主观和客观结果。他们在术前和术后6至12个月进行评分。
■在470例内窥镜鼻窦手术中,321(68.3%)为PESS,149(31.7%)为RESS。哮喘,阿司匹林敏感性,在RESS组中观察到更多的是Samter的三合会。初次和修正鼻窦手术的LK和LM评分有显著差异,提示PESS患者术后LK和LM评分较好。与PESS患者相比,RESS患者的术后SNOT-22评分明显更差。
■隆德-麦凯,Lund-Kennedy,原发性和翻修性ESS患者的SNOT-22评分在ESS后均得到改善,与RESS相比,PESS后观察到更好的结果。哮喘的存在,阿司匹林敏感性,Samter\的三合会,高度鼻息肉,年龄和年龄被确定为CRSwNP复发的危险因素,这可能需要RESS。
UNASSIGNED: Endoscopic sinus surgery (ESS) has become the gold standard for treating patients with chronic rhinosinusitis (CRS) refractory to medical therapy. It is considered a relatively safe and effective procedure in all age groups, with overall success rates ranging from 76% to 97.5%. However, failure of primary endoscopic sinus surgery (PESS) occurs at a rate ranging from 2% to 24%. Patients who are still symptomatic after PESS and optimal medical therapy are candidates for revision endoscopic sinus surgery (RESS).
UNASSIGNED: to study the outcomes of ESS and assess the risk factors of recurrence of nasal polyps, as well as to compare the outcomes of PESS and RESS at a tertiary care teaching hospital.
UNASSIGNED: A retrospective cross-sectional study.
UNASSIGNED: This study is conducted on patients with CRS with nasal polyps (CRSwNP) who underwent ESS at King Saud University Medical City (KSUMC) between May 2015 and December 2021. During this period, ESS was performed 470 times for CRSwNP. The Sinonasal Outcome Test 22 (SNOT-22) questionnaire, the Lund-Kennedy (LK) score, the Lund-MacKay (LM) score, and the polyp grading system were used to evaluate subjective and objective outcomes. They were scored preoperatively and from 6 to 12 months postoperatively.
UNASSIGNED: Out of the 470 endoscopic sinus surgeries, 321 (68.3%) were PESS and 149 (31.7%) were RESS. Asthma, aspirin sensitivity, and Samter\'s triad were observed more in the RESS group. The LK and LM scores were significantly different between primary and revision sinus surgeries, revealing that PESS patients had better postoperative LK and LM scores. The RESS patients had significantly worse postoperative SNOT-22 scores compared to PESS patients.
UNASSIGNED: Lund-MacKay, Lund-Kennedy, and SNOT-22 scores improved after ESS for both primary and revision ESS patients, with better outcomes observed after PESS compared to RESS. The presence of asthma, aspirin sensitivity, Samter\'s Triad, high-grade nasal polyps, and older age were identified as risk factors for CRSwNP recurrence, which may require RESS.