Department of Otolaryngology-Head and Neck Surgery, Georgia Regents University, Augusta, Georgia, U.S.A.
Laryngoscope. 2014 Jan;124(1):34-7. doi: 10.1002/lary.24220. Epub 2013 Jun 28.
OBJECTIVES/HYPOTHESIS: To demonstrate that quality-of-life outcomes after endoscopic sinus surgery are not compromised in patients with Samter's triad (asthma, nasal polyps, aspirin sensitivity) when compared to patients with eosinophilic chronic rhinosinusitis with nasal polyposis (eCRSwP) who are not aspirin sensitive.
Retrospective review of prospectively collected data.
Thirty-two patients with Samter's triad were identified from a prospectively collected patient database from 2003 to 2012. Preoperative and postoperative symptom and endoscopy scores were compared to those of 37 consecutive patients with eCRSwP who were not aspirin sensitive (control). Student t test and Fisher exact test were used to examine for differences between the two groups. Symptom scores were assessed using the 20-item Sino-Nasal Outcome Test (SNOT-20). Endoscopy findings were scored according to the Lund-Kennedy methodology.
Samter's triad patients had significantly worse disease preoperatively when compared to the control group: SNOT-20 (31.1 vs. 22.1, P = .004), endoscopy score (10.9 vs. 7.6, P = .0005), and Lund-Mackay computed tomography score (18.9 vs. 13.9, P = .0001). Although postoperative endoscopy scores remained worse in the Samter's triad group, postoperative SNOT-20 scores were comparable to those of the control group at ≥ 3 years follow-up (22.8 vs. 17.3, P = .43).
Although Samter's triad patients present with more severe disease and are more likely to undergo revision surgery, they have postoperative quality-of-life outcomes that are comparable to patients with eCRSwP who are not aspirin sensitive. This is the first study to utilize a disease-specific, validated outcomes instrument in comparing Samter's triad patients with aspirin-tolerant patients who have nasal polyposis and tissue eosinophilia.
目的/假设：通过比较非阿司匹林敏感的伴有嗜酸性粒细胞性慢性鼻-鼻窦炎伴鼻息肉（eCRSwP）和伴有阿司匹林敏感性的 Samter 三联征（哮喘、鼻息肉、阿司匹林敏感）患者的内镜鼻窦手术后生活质量结局，证明伴有阿司匹林敏感性的 Samter 三联征患者的内镜鼻窦手术后生活质量结局不会受到影响。
回顾性分析前瞻性收集的数据。
从 2003 年至 2012 年期间前瞻性收集的患者数据库中确定了 32 例伴有 Samter 三联征的患者。比较两组患者术前和术后症状和内镜评分。使用学生 t 检验和 Fisher 确切检验来比较两组之间的差异。症状评分采用 20 项 Sino-Nasal Outcome Test（SNOT-20）进行评估。内镜检查结果按照 Lund-Kennedy 评分法进行评分。
与对照组相比，Samter 三联征患者术前疾病严重程度显著更差：SNOT-20（31.1 对 22.1，P=0.004）、内镜评分（10.9 对 7.6，P=0.0005）和 Lund-Mackay 计算机断层扫描评分（18.9 对 13.9，P=0.0001）。尽管 Samter 三联征组患者术后内镜评分仍较差，但在≥3 年随访时，术后 SNOT-20 评分与对照组相当（22.8 对 17.3，P=0.43）。
尽管 Samter 三联征患者疾病更严重，更有可能接受翻修手术，但他们的术后生活质量结局与非阿司匹林敏感的伴有鼻息肉和组织嗜酸性粒细胞增多的 eCRSwP 患者相当。这是第一项使用疾病特异性、经验证的结局工具比较伴有阿司匹林敏感性的 Samter 三联征患者与阿司匹林耐受的伴有鼻息肉和组织嗜酸性粒细胞增多的患者的研究。
