Kay D J, Har-El G
Department of Otolaryngology, State University of New York Health Science Center at Brooklyn, Long Island College Hospital, USA.
Am J Rhinol. 2001 Jul-Aug;15(4):249-54.
The aim of this study was to define a role for endoscopic sinus surgery (ESS) in the treatment of chronic sinonasal sarcoidosis. All patients seen for sinonasal sarcoidosis in an otolaryngology practice in a tertiary care center from 1991 to 2000 were reviewed. Of 86 patients, 6 were treated with ESS for an operative rate of 7%. Surgeries were performed on those patients with significant sinonasal anatomic blockage. This included nasal obstruction from nasal polyposis and chronic and recurrent acute sinusitis from granulomatous lesions of the ostiomeatal complex. Patients remained symptom free for years after surgery on a nasal steroid regimen. Endoscopic sinus surgery is a viable treatment for those few patients with nasal obstruction or chronic sinusitis due to anatomic blockage from sinonasal sarcoidosis. Although it does not eradicate the disease or prevent recurrence, it does markedly improve quality of life by relieving severe symptoms and reducing the need for systemic steroids. This is the first study to advocate a role for surgery in sinonasal sarcoidosis beyond biopsy and management of complications. Although it may not be the appropriate approach for every patient, ESS certainly should be considered in the treatment options.
本研究的目的是明确鼻内镜鼻窦手术（ESS）在慢性鼻鼻窦结节病治疗中的作用。回顾了1991年至2000年在一家三级医疗中心耳鼻喉科就诊的所有鼻鼻窦结节病患者。86例患者中，6例接受了ESS治疗，手术率为7%。对那些有明显鼻鼻窦解剖阻塞的患者进行了手术。这包括鼻息肉引起的鼻塞以及窦口鼻道复合体肉芽肿性病变导致的慢性和复发性急性鼻窦炎。术后患者在使用鼻用类固醇治疗方案的情况下多年无症状。对于少数因鼻鼻窦结节病解剖阻塞而出现鼻塞或慢性鼻窦炎的患者，鼻内镜鼻窦手术是一种可行的治疗方法。虽然它不能根除疾病或预防复发，但通过缓解严重症状和减少全身类固醇的使用需求，确实能显著提高生活质量。这是第一项主张手术在鼻鼻窦结节病治疗中除活检和并发症处理之外具有作用的研究。虽然它可能不适用于每一位患者，但在治疗选择中肯定应考虑ESS。
