Facon F, Paris J, Guisiano B, Dessi P
Fédération d'ORL et de Chirurgie Cervico-Faciale, CHU de la Timone, Marseille, France.
Rev Laryngol Otol Rhinol (Bord). 2003;124(3):151-9.
Nasal polyposis is an invading disease whose evolution is dominated by functional symptoms. The aim of this study was to evaluate in cortico-resistant patients with nasal polyps the pre-operative functional symptoms in order to define factors that might increase them.
403 patients were included in this study. All of them met the inclusion criteria of follow-up and initial examination. Anosmia, pain, nasal obstruction, rhinorrhea and sneezing were evaluated by patients themselves. Radiological data, respiratory function test results and histological data were matched.
In our series, functional symptoms were dominated by anosmia, nasal obstruction and rhinorrhea. Pain and sneezing appeared to be less frequent. Analysis of co-variables allowed us to define factors which increased pre-operative functional symptoms. Some of them are well known (such as Fernand-Widal triad or stage 3 nasal polyposis), while others appear new or surprising. The same is true for frontal sinus involvement on CT-scan and glandular hyperplasia on histological study.
Analysis of the complete clinical, radiological and histological picture has allowed us to emphasise the importance of certain factors on the functional symptoms of 403 patients with polyps of the nose and sinuses, resistant to steroid treatment. The same is true for Widal's disease, for a higher endoscopic grading, for frontal sinus involvement, and for histological evidence of glandular hyperplasia.
鼻息肉病是一种侵袭性疾病，其病情发展以功能症状为主导。本研究的目的是评估皮质激素抵抗型鼻息肉患者的术前功能症状，以确定可能加重这些症状的因素。
本研究纳入了403例患者。他们均符合随访及初始检查的纳入标准。嗅觉减退、疼痛、鼻塞、流涕和打喷嚏由患者自行评估。将放射学数据、呼吸功能测试结果和组织学数据进行匹配。
在我们的研究系列中，功能症状以嗅觉减退、鼻塞和流涕为主。疼痛和打喷嚏似乎较少见。对协变量的分析使我们能够确定加重术前功能症状的因素。其中一些因素是众所周知的（如费尔南德 - 维达尔三联征或3期鼻息肉病），而其他一些因素则是新出现的或令人惊讶的。CT扫描显示的额窦受累情况以及组织学研究中的腺体增生情况也是如此。
对完整的临床、放射学和组织学情况进行分析，使我们能够强调某些因素对403例鼻及鼻窦息肉且对类固醇治疗抵抗的患者功能症状的重要性。维达尔病、更高的内镜分级、额窦受累以及腺体增生的组织学证据也是如此。
