Pincus Robert L, Kim Harold H, Silvers Stacy, Gold Scott
New York Otolaryngology Group, 36A E. 36th St., Suite 200, New York, NY 10016, USA.
Ear Nose Throat J. 2006 Mar;85(3):174-8.
Much discussion is taking place regarding the role of gastric reflux disease in the development and maintenance of chronic sinus disease. We studied 31 patients in a large urban private practice who had recalcitrant chronic sinusitis despite aggressive medical and surgical therapy. After we obtained information on the severity of each patient's sinus disease, we performed either double- or triple-catheter probe pH testing to assess the presence of reflux disease. Of the 30 patients who were successfully tested (1 patient did not tolerate probe testing), 25 demonstrated reflux disease, including 2 whose reflux reached the level of the nasopharynx. These 25 patients were placed on a proton-pump inhibitor (PPI) regimen and reassessed at least 1 month later. At follow-up, 14 of 15 evaluable patients demonstrated at least some improvement in their sinus symptoms, including 7 who experienced either a complete or almost-complete resolution of symptoms. The improvements in sinus symptoms corresponded with improvements in reflux symptoms. These findings suggest that antireflux therapy might play a role in the treatment of recalcitrant chronic sinus disease.
关于胃食管反流病在慢性鼻窦疾病发生和维持中的作用，目前有很多讨论。我们对一家大型城市私人诊所的31例患者进行了研究，这些患者尽管接受了积极的药物和手术治疗，但仍患有顽固性慢性鼻窦炎。在获取了每位患者鼻窦疾病的严重程度信息后，我们进行了双导管或三导管探头pH测试，以评估反流病的存在情况。在成功进行测试的30例患者中（1例患者不耐受探头测试），25例显示存在反流病，其中2例反流达到鼻咽部水平。这25例患者接受质子泵抑制剂（PPI）治疗方案，并在至少1个月后重新评估。在随访时，15例可评估患者中有14例鼻窦症状至少有一定改善，其中7例症状完全或几乎完全缓解。鼻窦症状的改善与反流症状的改善相对应。这些发现表明，抗反流治疗可能在顽固性慢性鼻窦疾病的治疗中发挥作用。
