Dejima Kenji, Adachi Naoko, Oshima Akihiro, Nishimura Yasuhiko, Uchida Masaya, Ushijima Chihisa, Hama Takemitsu, Hisa Yasuo
Department of Otorhinolaryngology, Kyoto Second Red Cross Hospital, Kyoto.
Nihon Jibiinkoka Gakkai Kaiho. 2008 Feb;111(2):58-64. doi: 10.3950/jibiinkoka.111.58.
Intractable sinusitis is, in most cases, complicated by bronchial asthma and severe eosinophilic infiltration of the sinus mucosa. Our aim here was to study the postoperative outcomes of chronic sinusitis complicated/not complicated by bronchial asthma and of cases with eosinophilic sinusitis/non-eosinophilic sinusitis.
We conducted a prospective analysis of the outcome of 180 patients with or without bronchial asthma and eosinophilic infiltration who underwent endoscopic sinus surgery (ESS) for chronic sinusitis. The patients were divided into four groups by the presence/absence of asthma and presence/absence of eosinophilic infiltration of the sinus mucosa. One surgeon performed the ESS, and all the groups received the same postoperative treatment.
The outcomes of ESS were significantly worse in the cases complicated by eosinophilic sinusitis and asthma, especially in relation to the incidence of smell disturbances and the endonasal findings. Patients suffering from chronic sinusitis without asthma showed good improvement following ESS. There was no significant differences in the outcome after ESS between cases of eosinophilic sinusitis and those with non-eosinophilic sinusitis among the patients without asthma.
We contend that eosinophilic sinusitis without asthma may not represent intractable sinusitis. We wish to emphasize that complication by
在大多数情况下，难治性鼻窦炎并发支气管哮喘，且鼻窦黏膜有严重嗜酸性粒细胞浸润。我们的目的是研究慢性鼻窦炎合并/不合并支气管哮喘以及嗜酸性粒细胞性鼻窦炎/非嗜酸性粒细胞性鼻窦炎患者的术后结果。
我们对180例因慢性鼻窦炎接受鼻内镜鼻窦手术（ESS）的患者进行了前瞻性分析，这些患者有或没有支气管哮喘及嗜酸性粒细胞浸润。根据是否存在哮喘以及鼻窦黏膜是否存在嗜酸性粒细胞浸润，将患者分为四组。由一名外科医生进行ESS，所有组接受相同的术后治疗。
嗜酸性粒细胞性鼻窦炎合并哮喘的病例中，ESS的结果明显更差，尤其是在嗅觉障碍发生率和鼻内检查结果方面。患有慢性鼻窦炎但无哮喘的患者在ESS后有良好改善。在无哮喘的患者中，嗜酸性粒细胞性鼻窦炎病例和非嗜酸性粒细胞性鼻窦炎病例在ESS后的结果没有显著差异。
我们认为无哮喘的嗜酸性粒细胞性鼻窦炎可能并不代表难治性鼻窦炎。我们希望强调……的并发症
