Bugten Vegard, Nordgård Ståle, Romundstad Pål, Steinsvåg Sverre
Department of Otolaryngology, Head and Neck Surgery, St Olav University Hospital of Trondheim, and Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Rhinology. 2008 Mar;46(1):40-4.
Nasal polyposis (NP) is considered to be a subgroup of chronic rhinosinusitis (CRS). However differences in cellular and mediator profiles suggest that they could be distinct entities.
To look for group differences in characteristics and symptom severity before and after surgery in patients suffering from CRS and bilateral NP that could clinically support the hypothesis that NP and CRS are different pathological processes and to compare the effect of functional endoscopic sinus surgery (FESS) in CRS patients and NP patients.
Forty-five patients with CRS and 57 patients with bilateral NP were included in this prospective trial. We used t-tests for independent groups to compare preoperative symptoms as recorded on visual analogue scale (VAS). To evaluate if there were differences in symptom improvement between the groups we used analysis of covariance. Categorical variables were compared using exact tests.
Mean age was 38 years for the CRS group and 47 years for the NP group, the difference was significant (p = 0.0001). NP patients underwent significantly more posterior ethmoidectomies than patients suffering from CRS (p = 0.001), and asthma was significantly more prevalent in NP than in CRS (p = 0.007). Comparing preoperative symptoms as recorded on VAS we found significant differences. While patients with NP suffered significantly more from nasal blockage and change in their sense of smell than CRS patients, patients with CRS presented with more facial pain and headache. There were no differences in symptom improvement, as both conditions responded similarly to FESS.
Differences in symptom severity, nasal endoscopy, age of patients and prevalence of asthma indicate that NP and CRS are different entities. Nevertheless, both conditions respond similarly to FESS.
鼻息肉病（NP）被认为是慢性鼻-鼻窦炎（CRS）的一个亚组。然而，细胞和介质特征的差异表明它们可能是不同的实体。
寻找CRS和双侧NP患者手术前后特征及症状严重程度的组间差异，以临床支持NP和CRS是不同病理过程的假说，并比较功能性鼻内镜鼻窦手术（FESS）对CRS患者和NP患者的效果。
本前瞻性试验纳入了45例CRS患者和57例双侧NP患者。我们使用独立样本t检验比较视觉模拟量表（VAS）记录的术前症状。为评估两组间症状改善是否存在差异，我们使用协方差分析。分类变量使用确切检验进行比较。
CRS组的平均年龄为38岁，NP组为47岁，差异有统计学意义（p = 0.0001）。NP患者比CRS患者接受后筛窦切除术的比例显著更高（p = 0.001），且哮喘在NP患者中的患病率显著高于CRS患者（p = 0.007）。比较VAS记录的术前症状，我们发现了显著差异。与CRS患者相比，NP患者鼻阻塞和嗅觉改变的症状更严重，而CRS患者面部疼痛和头痛更明显。症状改善方面没有差异，因为两种疾病对FESS的反应相似。
症状严重程度、鼻内镜检查、患者年龄和哮喘患病率的差异表明NP和CRS是不同的实体。然而，两种疾病对FESS的反应相似。
