Division of Otolaryngology-Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, Utah 84132, USA.
Otolaryngol Head Neck Surg. 2013 Jul;149(1):30-9. doi: 10.1177/0194599813488744. Epub 2013 May 14.
Review the literature for intraoperative techniques and postoperative practices after functional endoscopy sinus surgery (FESS) that may improve outcomes in patients with cystic fibrosis (CF).
PubMed and the Cochrane Library.
A systematic review of the literature was performed. Articles from 1990 to 2012 were searched using the terms sinus surgery and cystic fibrosis with studies limited to the English language and human subjects. Abstracts were reviewed to identify relevant original manuscripts. Bibliographies of relevant articles were examined to identify additional manuscripts.
The initial PubMed search identified 169 articles. One additional article was identified through the Cochrane Library. After reviewing the abstracts, 41 selected studies were examined in further detail, and 22 articles were ultimately selected for suitability for this review. The bibliographies of these articles were reviewed and no additional articles were identified. Perioperative strategies included postoperative medical therapies, intraoperative techniques and image guidance, intranasal corticosteroid injection, dornase alfa, gene therapy, and second-look procedures. Most studies were limited to case series with relatively small numbers of patients. Very few randomized controlled studies were identified.
Despite the prevalence of recurrent sinonasal disease after FESS in patients with CF, evidence for definitive perioperative management in this population is lacking. Most recommendations are based on small case series. Multicenter studies to evaluate perioperative strategies that improve FESS outcomes in patients with CF are warranted.
回顾功能性内镜鼻窦手术（FESS）后改善囊性纤维化（CF）患者手术效果的术中技术和术后操作的文献。
PubMed 和 Cochrane 图书馆。
对文献进行了系统的回顾。使用“鼻窦手术”和“囊性纤维化”这两个术语，对 1990 年至 2012 年的文章进行了搜索，研究仅限于英语和人类受试者。对摘要进行了审查，以确定相关的原始手稿。检查了相关文章的参考文献，以确定其他手稿。
最初的 PubMed 搜索确定了 169 篇文章。通过 Cochrane 图书馆又发现了一篇文章。在审查了摘要之后，进一步详细检查了 41 项选定的研究，最终有 22 篇文章适合进行本综述。还审查了这些文章的参考文献，但未发现其他文章。围手术期策略包括术后药物治疗、术中技术和图像引导、鼻内皮质类固醇注射、脱氧核糖核酸酶 alfa、基因治疗和二次手术。大多数研究仅限于病例系列，患者数量相对较少。很少有随机对照研究被发现。
尽管 CF 患者 FESS 后复发性鼻旁窦疾病很常见，但缺乏针对该人群的明确围手术期管理的证据。大多数建议都是基于小病例系列。需要进行多中心研究，以评估改善 CF 患者 FESS 结果的围手术期策略。
