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全身用类固醇治疗鼻-鼻窦炎鼻息肉的疗效

Efficacy of systemic steroid treatment in sinonasal polyposis.

作者信息

Berkiten Güler, Salturk Ziya, Topaloğlu Ilhan

机构信息

Okmeydanı Training and Research Hospital, ENT Clinic, Istanbul, Turkey.

出版信息

J Craniofac Surg. 2013 May;24(3):e305-8. doi: 10.1097/SCS.0b013e31828f261f.

Abstract

AIM

Nasal polyposis is an inflammatory disease of unknown origin. Systemic steroid treatment is effective not only in decreasing polyp size but also in controlling mucosal inflammation. We evaluated the efficacy of mean-term systemic corticosteroid treatment in nasal polyposis clinically and radiologically.

METHODS

Seventy-five patients with nasal polyposis were included in this study. Patients were treated with methylprednisolone for 20 days. Clinical response was evaluated by nasal symptom scores and changes in polyp size; disease extent was assessed by paranasal sinus tomography. Nasal symptom score, polyp size, and disease extent were reevaluated after therapy.

RESULTS

Twenty-one (28%) of 75 patients were female, and 54 (72%) were male. The mean age was 41.63 ± 11.04 with a range of 17 to 80 years. As shown radiologically, 26.7% (n = 20) of patients completely healed, and 41.3% (n = 31) partially healed, whereas there was no improvement in 32% (n = 24). There was a statistically significant improvement in radiological assessment (P < 0.01). The sense of smell showed the greatest improvement (56.98%). The least-improved symptoms were facial pain and headache (37.74%). There was a statistically significant decrease in polyp grade (P < 0.01).

CONCLUSIONS

Systemic steroid treatment caused a decrease in all nasal symptoms and polyp size and improved paranasal computed tomography results. In addition, it shortened the duration of surgery and improved the quality of the procedure. Systemic steroid treatment also contributed to the prevention of recurrence.

摘要

目的

鼻息肉病是一种病因不明的炎症性疾病。全身用类固醇治疗不仅对减小息肉大小有效,而且对控制黏膜炎症也有效。我们从临床和影像学方面评估了中期全身用皮质类固醇治疗鼻息肉病的疗效。

方法

本研究纳入了75例鼻息肉病患者。患者接受甲泼尼龙治疗20天。通过鼻症状评分和息肉大小变化评估临床反应;通过鼻窦CT评估疾病范围。治疗后重新评估鼻症状评分、息肉大小和疾病范围。

结果

75例患者中21例(28%)为女性,54例(72%)为男性。平均年龄为41.63±11.04岁,范围为17至80岁。影像学显示,26.7%(n = 20)的患者完全治愈,41.3%(n = 31)的患者部分治愈,而32%(n = 24)的患者无改善。影像学评估有统计学显著改善(P < 0.01)。嗅觉改善最为明显(56.98%)。改善最少的症状是面部疼痛和头痛(37.74%)。息肉分级有统计学显著降低(P < 0.01)。

结论

全身用类固醇治疗使所有鼻症状和息肉大小减小,并改善了鼻窦CT结果。此外,它缩短了手术时间并提高了手术质量。全身用类固醇治疗还有助于预防复发。

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