Tanta University Hospitals, Tanta, Egypt.
Rhinology. 2010 Sep 1;48(3):305-11. doi: 10.4193/Rhin08.137.
To conduct the first prospective randomized controlled trial, evaluating and comparing the effect of medical and surgical treatment of chronic rhinosinusitis (CRS) on quality of life.
Ninety patients with CRS, who remained symptomatic after initial medical treatment with Dexarhinaspray duo and nasal douche, were randomized either to medical or surgical therapy. All patients underwent pre- and post-treatment assessments of the Sinonasal Outcome Test-20 (SNOT-20), and the Short Form 36 Health Survey (SF-36). Each patient had three assessments: before starting the randomized treatment, after six months and finally after one year.
Both the medical and surgical treatment of CRS significantly improved almost all the parameters of SNOT and SF-36 (p<0.05), with no significant difference being found between the medical and surgical groups (p>0.05).
Both maximal medical and surgical therapy of CRS improves the quality of life of CRS patients, providing further evidence that chronic rhinosinusitis should be targeted with maximal medical therapy in the first instance, with surgical treatment being reserved for cases refractory to medical therapy. The presence of nasal polyps does not imply any negative effect on the quality of life after CRS therapy, either medical or surgical.
进行首个前瞻性随机对照试验，评估和比较慢性鼻-鼻窦炎（CRS）的药物和手术治疗对生活质量的影响。
90 例 CRS 患者，在初始使用 Dexarhinaspray duo 和鼻腔冲洗治疗后仍有症状，随机分为药物或手术治疗组。所有患者均在治疗前和治疗后 6 个月和 1 年进行鼻-鼻窦结局测试 20 项（SNOT-20）和健康调查简表 36 项（SF-36）评估。每位患者有 3 次评估：开始随机治疗前、治疗后 6 个月和 1 年后。
CRS 的药物和手术治疗均显著改善了 SNOT 和 SF-36 的几乎所有参数（p<0.05），药物和手术组之间无显著差异（p>0.05）。
CRS 的最大程度药物和手术治疗均改善了 CRS 患者的生活质量，进一步证明慢性鼻-鼻窦炎应首先采用最大程度的药物治疗，手术治疗保留给药物治疗无效的病例。鼻息肉的存在并不意味着 CRS 治疗后对生活质量有任何负面影响，无论是药物治疗还是手术治疗。
