Dudvarski Zoran, Pendjer Ivica, Djukic Vojko, Janosevic Ljiljana, Mikic Anton
Institute of Otorhinolaryngology and Maxillofacial Surgery, Clinical Center of Serbia, 2, Pasterova street, 11000 Belgrade, Serbia.
Eur Arch Otorhinolaryngol. 2008 Aug;265(8):923-7. doi: 10.1007/s00405-008-0587-y. Epub 2008 Feb 5.
The objective of our study was to analyze the intensity of subjective symptoms and objective findings of endoscopy and CT scanning in chronic rhinosinusitis, in the groups with and without nasal polyps. To evaluate the intensity of subjective symptoms visual analogue scale (VAS) was used, while scores were obtained by adding grades. Endoscopic finding was given in scores recommended by Lanza and Kennedy and CT results were presented by Lund-Mackay scoring system. The study included 90 consecutive adult patients, 47 males (52%) and 43 females (48%), mean age 45 years. The group with chronic rhinosinusitis without nasal polyps (uncomplicated form) consisted of 30 patients, while the group with polyps (complicated form) included 60 patients. Comparing mean intensity values of all subjective symptoms between these two groups we found out that nasal obstruction, nasal secretion and hyposmia were significantly more manifested in the polyp group (P<0.01). Facial congestion was also more manifested in the polyp group (P<0.05). Mean score value of major symptoms was 35.55 in the polyp group, and 23.13 in the group without polyps (P<0.01). Mean value of total symptom scores was 48.68 in the polyp group, and 35.00 in the group without polyps (P<0.01). Endoscopic score was approximately 9.03 in the polyp group, and 2.43 in the group without polyps (P<0.01). CT score was 16.05 on an average in the polyp group, and 4.37 in the group without polyps (P<0.01). Chronic rhinosinusitis complicated by nasal polyposis is characterized by higher degree of nasal obstruction, nasal secretion, hyposmia and facial congestion, which results in higher score of major and total score of symptoms, respectively. This form is also characterized by worse objective findings, which is reflected in higher endoscopic and CT scores.
我们研究的目的是分析慢性鼻窦炎患者中,有鼻息肉组和无鼻息肉组的主观症状强度以及内镜检查和CT扫描的客观结果。采用视觉模拟量表(VAS)评估主观症状强度,通过累加等级获得分数。内镜检查结果采用Lanza和Kennedy推荐的评分,CT结果采用Lund-Mackay评分系统呈现。该研究纳入了90例连续的成年患者,其中男性47例(52%),女性43例(48%),平均年龄45岁。无鼻息肉的慢性鼻窦炎组(单纯型)有30例患者,有鼻息肉组(复杂型)有60例患者。比较两组所有主观症状的平均强度值,我们发现鼻阻塞、鼻分泌物和嗅觉减退在息肉组中表现更为显著(P<0.01)。面部充血在息肉组中也更为明显(P<0.05)。息肉组主要症状的平均得分值为35.55,无息肉组为23.13(P<0.01)。息肉组总症状得分的平均值为48.68,无息肉组为35.00(P<0.01)。息肉组内镜评分为9.03左右,无息肉组为2.43(P<0.01)。息肉组CT评分平均为16.05,无息肉组为4.37(P<0.01)。合并鼻息肉的慢性鼻窦炎的特点是鼻阻塞、鼻分泌物、嗅觉减退和面部充血程度更高,分别导致主要症状得分和总症状得分更高。这种类型还具有更差的客观检查结果,这体现在更高的内镜和CT评分上。