Macdonald Kristian I, McNally James D, Massoud Emad
Division of Otolaryngology-Head and Neck Surgery, Dalhousie University, Halifax, Nova Scotia.
J Otolaryngol Head Neck Surg. 2009 Apr;38(2):286-93.
To measure the impact of chronic rhinosinusitis (CRS) on the health of Nova Scotians and evaluate the role of surgery in modifying this impact.
Nova Scotia residents with CRS referred to one otolaryngologist were enrolled. The Chronic Sinusitis Survey (CSS) and Short Form 36-Item Health Survey (SF-36) were administered preoperatively and at two postoperative visits. The SF-36 data were compared with Canadian published norms. Also, the postoperative survey results were compared with preoperative data to evaluate the role of surgery in improving health.
Thirty-eight patients completed preoperative and 3-month forms, and 26 patients completed preoperative and 3- and 12-month postoperative forms. Patients with CRS showed a significant decrease in five of eight SF-36 subscales. Surgery significantly improved preoperative scores for six of eight subscales and both the physical (PCS) and mental (MCS) component summary scores (p < .05). Males were more likely than females to report postoperative improvements (p = .02). Males under 50 years were more likely to show improvement in the PCS score (p = .02), with no significant change in the MCS score. Females under 50 years were more likely to show improvement in the MCS score (p = .02), with age having no effect on PCS score.
This study confirms that Canadians with CRS have lower quality of life and for the first time in Canada demonstrates that functional endoscopic sinus surgery can restore health. Males showed a greater response than females, and patients under 50 years were more likely to improve after surgery. This information on patient factors influencing outcomes may help physicians when counseling patients regarding surgery for CRS.
评估慢性鼻窦炎（CRS）对新斯科舍省居民健康的影响，并评价手术在改善这种影响方面的作用。
招募转诊至一位耳鼻喉科医生处的新斯科舍省CRS患者。在术前以及术后两次随访时进行慢性鼻窦炎调查问卷（CSS）和36项简短健康调查问卷（SF-36）。将SF-36数据与加拿大公布的标准进行比较。此外，将术后调查结果与术前数据进行比较，以评估手术在改善健康方面的作用。
38例患者完成了术前及3个月的问卷，26例患者完成了术前、术后3个月及12个月的问卷。CRS患者在SF-36的八个分量表中有五个显著下降。手术使八个分量表中的六个以及身体（PCS）和心理（MCS）综合得分显著提高（p < .05）。男性比女性更有可能报告术后有所改善（p = .02）。50岁以下男性的PCS得分更有可能提高（p = .02），而MCS得分无显著变化。50岁以下女性的MCS得分更有可能提高（p = .02），年龄对PCS得分无影响。
本研究证实加拿大CRS患者生活质量较低，并且在加拿大首次表明功能性鼻内镜鼻窦手术可以恢复健康。男性的反应比女性更大，50岁以下患者术后更有可能改善。这些关于影响手术结果的患者因素的信息可能有助于医生在为CRS患者提供手术咨询时参考。
