Rhee John S, Book David T, Burzynski Mary, Smith Timothy L
Department of Otolaryngology and Communucation Sciences, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA.
Laryngoscope. 2003 Jul;113(7):1118-22. doi: 10.1097/00005537-200307000-00004.
OBJECTIVES/HYPOTHESIS: Quality of life (QOL) assessment of patients with nasal obstruction has not been well studied. The objectives of the study were to determine the QOL of patients with nasal obstruction, to identify baseline variables predictive of patients' QOL, and to examine the relationship of QOL scores with patient assessment of nasal obstruction.
Preliminary, cross-sectional study of a larger, prospective investigation.
Forty individuals met the criteria for inclusion. Participants were required to have a surgically treatable diagnosis of septal deviation, nasal valve collapse, and/or turbinate hypertrophy. Quality of life assessment was performed using the Rhinoconjunctivitis Quality of Life Questionnaire and the Rhinosinusitis Disability Index. Demographic data, along with patient assessment of nasal obstruction with a visual analogue scale, were recorded.
Both instruments demonstrated good inter-item correlation as measured by Cronbach's alpha. Demographic variables, previous nasal surgeries, and comorbid conditions were not significantly correlated with QOL scores with either instrument. Correlations between visual analogue scale scores and the Rhinoconjunctivitis Quality of Life Questionnaire "sleep" (correlation coefficient [r] = 0.35, P =.02) and "nasal symptom" (r = 0.36, P =.02) domains demonstrated a trend toward significance. Patients with nasal valve collapse reported higher visual analogue scale scores for nasal obstruction compared with those with septal deviation alone (P <.01).
Patients with nasal valve collapse demonstrated greater perception of nasal obstruction than those with septal deviation alone. The Rhinoconjunctivitis Quality of Life Questionnaire appears to be a more sensitive instrument than the Rhinosinusitis Disability Index for patients with nasal obstruction. However, existing measures may lack sensitivity in estimating the QOL of patients with nasal obstruction. A disease-specific instrument for nasal obstruction may be necessary to further evaluate this disease process.
目的/假设：鼻阻塞患者的生活质量（QOL）评估尚未得到充分研究。本研究的目的是确定鼻阻塞患者的生活质量，识别预测患者生活质量的基线变量，并研究生活质量评分与患者对鼻阻塞评估之间的关系。
一项更大规模前瞻性研究的初步横断面研究。
40名个体符合纳入标准。参与者必须有可通过手术治疗的鼻中隔偏曲、鼻瓣膜塌陷和/或鼻甲肥大诊断。使用变应性鼻炎生活质量问卷和鼻窦炎残疾指数进行生活质量评估。记录人口统计学数据以及患者用视觉模拟量表对鼻阻塞的评估。
两种工具通过克朗巴哈系数测量均显示出良好的项目间相关性。人口统计学变量、既往鼻部手术和合并症与两种工具的生活质量评分均无显著相关性。视觉模拟量表评分与变应性鼻炎生活质量问卷“睡眠”（相关系数[r]=0.35，P=0.02）和“鼻部症状”（r=0.36，P=0.02）领域之间的相关性显示出显著趋势。与单纯鼻中隔偏曲患者相比，鼻瓣膜塌陷患者报告的鼻阻塞视觉模拟量表评分更高（P<0.01）。
与单纯鼻中隔偏曲患者相比，鼻瓣膜塌陷患者对鼻阻塞的感知更强。对于鼻阻塞患者，变应性鼻炎生活质量问卷似乎比鼻窦炎残疾指数更敏感。然而，现有测量方法在估计鼻阻塞患者的生活质量方面可能缺乏敏感性。可能需要一种针对鼻阻塞的疾病特异性工具来进一步评估这一疾病过程。
