Lee Jae Yong, Lee Seung Won
Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon, South Korea.
Laryngoscope. 2007 Jun;117(6):1084-9. doi: 10.1097/MLG.0b013e318058197a.
To determine whether patient age is associated with the surgical outcome after endoscopic sinus surgery (ESS) with polypectomy.
A prospective, controlled case series.
This study consisted of 60 patients who were diagnosed as having chronic rhinosinusitis (CRS) with nasal polyposis (NP) that was refractory to medical treatment. Three groups were classified according to patient age: pediatric (5-18 yr), adult (19-65 yr), and geriatric (over 65 yr). We collected 20 patients in each age group after applying the exclusion criteria. The extent of the polyps and the Lund-Mackay score were calculated for each patient, and they underwent ESS with polypectomy. We compared the objective endoscopic findings and subjective improvements in symptoms among the groups 6 months after the procedure.
There were no statistical differences in polyp extent or Lund-Mackay score between the three age groups. The objective surgical outcome based on the endoscopic findings was worst in the pediatric group (45%), whereas the geriatric group showed the best results (90%). The differences in objective outcome among the three groups were significant, and patient age was a predictive variable for surgical result based on multiple logistic regression analysis. No major complications occurred, and the overall improvement in subjective symptoms was statistically significant in all three age groups at 6 months postoperatively. The subjective surgical outcome did not differ statistically between the groups, with the exception of olfactory disturbance.
The results of the present study suggest that patient age influences the objective postoperative outcome in the endoscopic treatment of CRS with NP, and that ESS is an effective and reliable method for improving the subjective symptoms in patients of all age groups despite the statistically different objective surgical outcomes between the groups.
确定患者年龄与内镜鼻窦手术（ESS）联合息肉切除术的手术效果是否相关。
一项前瞻性对照病例系列研究。
本研究纳入60例被诊断为慢性鼻窦炎（CRS）伴鼻息肉（NP）且药物治疗无效的患者。根据患者年龄分为三组：儿童组（5 - 18岁）、成人组（19 - 65岁）和老年组（65岁以上）。在应用排除标准后，每组收集20例患者。计算每位患者的息肉范围和Lund - Mackay评分，然后他们接受ESS联合息肉切除术。我们比较了术后6个月各组间的客观内镜检查结果和主观症状改善情况。
三组之间在息肉范围或Lund - Mackay评分上无统计学差异。基于内镜检查结果的客观手术效果在儿童组最差（45%），而老年组效果最佳（90%）。三组间客观结果的差异具有统计学意义，基于多因素逻辑回归分析，患者年龄是手术结果的预测变量。未发生重大并发症，术后6个月时所有三个年龄组主观症状的总体改善具有统计学意义。除嗅觉障碍外，各组间主观手术效果无统计学差异。
本研究结果表明，患者年龄会影响CRS伴NP内镜治疗的术后客观效果，并且尽管各组间客观手术效果存在统计学差异，但ESS是改善各年龄组患者主观症状的有效且可靠的方法。
