Hoseini S M S, Saedi B, Aghazadeh K
Otolaryngology Department, Tehran University of Medical Sciences, Iran.
J Laryngol Otol. 2012 Aug;126(8):789-94. doi: 10.1017/S0022215112001193.
To evaluate the effect of meticulous endoscopic surgery, including opening of all involved sinus cells, on the subsequent symptoms and endoscopic findings of patients with massive nasal polyposis.
One hundred patients with massive nasal polyposis resistant to medical treatment were selected. We documented each patient's demographic data, associated diseases, endoscopic findings, Lund-Mackay score and Sino-Nasal Outcome Test 22 (SNOT22) symptom score. All patients were followed up for at least two years to evaluate any recurrence.
Of the 100 patients, 20 per cent had a history of asthma and 27 per cent had undergone previous surgery. All underwent endoscopic sinus surgery. After two years of follow up, 8 per cent had recurrence requiring surgery. Recurrence was significantly associated with a history of asthma (p < 0.001) and the histopathological presence of eosinophilia (p = 0.014).
Meticulous endoscopic opening of all involved sinus cells can be a safe and effective means of controlling massive nasal polyposis, with an acceptable recurrence rate.
评估精细内镜手术（包括开放所有受累鼻窦小房）对重度鼻息肉患者后续症状及内镜检查结果的影响。
选取100例药物治疗无效的重度鼻息肉患者。记录每位患者的人口统计学数据、相关疾病、内镜检查结果、Lund-Mackay评分及鼻鼻窦结局测试22（SNOT22）症状评分。所有患者均随访至少两年以评估有无复发。
100例患者中，20%有哮喘病史，27%曾接受过手术。所有患者均接受了内镜鼻窦手术。随访两年后，8%的患者复发需要再次手术。复发与哮喘病史（p<0.001）及嗜酸性粒细胞的组织病理学存在（p = 0.014）显著相关。
精细内镜开放所有受累鼻窦小房可作为控制重度鼻息肉的一种安全有效的方法，复发率可接受。
