Corey G A, Rodney W M, Hocutt J E
Duluth Clinic, Minnesota.
J Fam Pract. 1990 Jul;31(1):49-52.
A case series is presented consisting of 210 symptomatic patients evaluated by family physicians using fiberoptic rhinolaryngoscopy. The case series is analyzed to evaluate patient tolerance of the procedure, to measure the time required for the procedure, and to explore the clustering of diagnostic findings as they relate to presenting symptoms. Family physicians performed the examinations in an average of 4.4 minutes, with a median discomfort score of 2 on a scale of 0 to 10. A change in the diagnostic assessment or management plan following examination occurred in 90% of cases. Laryngeal pathology was identified in 73% of patients with chronic hoarseness, 60% of patients with both chronic hoarseness and nasal symptoms, and 3% of patients complaining of chronic nasal symptoms only. Nasal polyps or purulent drainage from the sinus ostia were found in 28% of patients with chronic nasal symptoms, 30% of patients with both chronic hoarseness and nasal symptoms, and 2% of patients with chronic hoarseness only. Incomplete examination (because of gagging) occurred in only 1 of 210 cases. This study demonstrated high diagnostic yield, rapid acquisition of technical skill, minimal patient discomfort, significant impact on diagnosis and management, and minimal time required for examination.
本文呈现了一个病例系列，包含210名有症状的患者，这些患者由家庭医生使用纤维鼻咽喉镜进行评估。对该病例系列进行分析，以评估患者对该操作的耐受性、测量操作所需时间，并探索与呈现症状相关的诊断结果的聚类情况。家庭医生进行检查的平均时间为4.4分钟，在0至10分的量表上，不适中位数评分为2分。90%的病例在检查后诊断评估或管理计划发生了改变。在73%的慢性声音嘶哑患者、60%的既有慢性声音嘶哑又有鼻部症状的患者以及仅主诉慢性鼻部症状的患者中发现了喉部病变。在28%的慢性鼻部症状患者、30%的既有慢性声音嘶哑又有鼻部症状的患者以及仅慢性声音嘶哑的患者中发现了鼻息肉或鼻窦开口处的脓性分泌物。在210例病例中，只有1例因 gagging 而检查不完整。这项研究表明诊断率高、技术技能获取迅速、患者不适最小、对诊断和管理有重大影响且检查所需时间最短。
