Seyring C, Bitter T, Böger D, Büntzel J, Eßer D, Hoffmann K, Jecker P, Müller A, Radtke G, Guntinas-Lichius O
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Laryngorhinootologie. 2012 Jul;91(7):434-9. doi: 10.1055/s-0032-1304592. Epub 2012 Mar 9.
Although modern minimal-invasive paranasal sinus surgery is an integral part of clinical routine of otorhinolaryngologic surgeons, there are no population-based data on incidence and efficiency of this surgery published.
1,582 patients underwent paranasal sinus surgery in the 8 Thuringian departments of otorhinolaryngology in 2005. All patients were analysed regarding patients' characteristics, therapy, complications and further course of disease.
The incidence of paranasal sinus surgery was 46/100,000 for women and higher for men with 72/100,000. Median age was 48 years. Chronic sinusitis was the main reason for surgery (94%; including 33% with nasal polyps) and was performed dominantly as endoscopic sinus surgery (96%). Surgery was performed bilaterally in 75% of the cases and as primary surgery. In most cases at least 2 paranasal sinuses per side were approached. Relevant complications were observed in 4% of patients. During the follow-up time of 45-51 months a recurrence was observed in 9% of cases. Using a multivariate regression analysis, revision surgery, allergic subject and diagnosis of a malignant tumor were significant independent risk factors to predict a recurrence. Older age and longer time of surgery were significant independent risk factors for a complication.
This population based analysis is showing that modern paranasal sinus surgery is performed in high incidence, effectively and with low-risk on a large scale in daily routine of rhinologic surgeons.
尽管现代鼻旁窦微创手术是耳鼻喉科临床常规工作的一个组成部分,但尚无基于人群的该手术发病率及疗效数据发表。
2005年,图林根州8个耳鼻喉科部门的1582例患者接受了鼻旁窦手术。对所有患者的特征、治疗、并发症及疾病的后续病程进行了分析。
女性鼻旁窦手术发病率为46/100,000,男性更高,为72/100,000。中位年龄为48岁。慢性鼻窦炎是手术的主要原因(94%;包括33%伴有鼻息肉),主要采用鼻内镜鼻窦手术(96%)。75%的病例为双侧手术且为初次手术。大多数情况下,每侧至少处理2个鼻旁窦。4%的患者出现相关并发症。在45 - 51个月的随访期内,9%的病例出现复发。通过多因素回归分析,翻修手术、过敏体质及恶性肿瘤诊断是预测复发的显著独立危险因素。年龄较大和手术时间较长是并发症的显著独立危险因素。
这项基于人群的分析表明,在鼻科医生的日常工作中,现代鼻旁窦手术发病率高、疗效显著且风险低。