Johns Hopkins Department of Otolaryngology-Head and Neck Surgery, Baltimore, MD.
Int Forum Allergy Rhinol. 2014 Jan;4(1):22-8. doi: 10.1002/alr.21232. Epub 2013 Oct 7.
The objective of this study was to systematically review existing literature on the association between sinusitis and secondhand smoke (SHS) exposure.
We performed a literature search encompassing the last 25 years in PubMed, EMBASE, and Cochrane CENTRAL. Inclusion criteria included English language papers containing original human data with at least 7 subjects. Data was systematically collected on study design, patient demographics, clinical characteristics/outcomes, and level-of-evidence (Oxford Center for Evidence-Based Medicine). Quality assessment was performed using the Newcastle-Ottawa scale. Two investigators independently reviewed all manuscripts.
The initial search yielded 116 abstracts, of which 19 articles were included. Thirteen (68.4%) of the 19 articles showed a statistically significant association between sinusitis and SHS. Seven (36.8%) studies specifically evaluated chronic rhinosinusitis (CRS) with 5 (71.4%) CRS studies demonstrating a significant association between CRS and SHS. Seventeen articles were case-control studies (Level 3b). For characterizing sinusitis, 6 (31.6%) studies included computed tomography (CT) or endoscopy in the diagnostic criteria, with 5 of these studies following rhinosinusitis taskforce guidelines. For determining presence of SHS, all studies used questionnaires and 2 (10.5%) studies also reported serum or urine cotinine levels.
A majority of the studies (68.4%) included in this systematic review showed a significant association between sinusitis and SHS. Furthermore, 5 (83.3%) of the 6 studies with objective diagnostic criteria (CT, endoscopy) found a significant association between sinusitis and SHS. Further higher-quality studies with objective diagnosis of sinusitis and quantification of SHS exposure should be performed in the future to better evaluate the relationship between sinusitis and SHS.
本研究旨在系统回顾有关鼻窦炎与二手烟（SHS）暴露相关性的现有文献。
我们在 PubMed、EMBASE 和 Cochrane CENTRAL 中进行了文献检索，涵盖过去 25 年的文献。纳入标准包括含有至少 7 名受试者的原始人类数据的英文论文。系统收集了研究设计、患者人口统计学、临床特征/结局以及证据水平（牛津循证医学中心）的数据。使用纽卡斯尔-渥太华量表进行质量评估。两名研究人员独立审查了所有手稿。
最初的搜索产生了 116 份摘要，其中 19 篇文章被纳入。19 篇文章中的 13 篇（68.4%）显示鼻窦炎与 SHS 之间存在统计学显著关联。7 篇（36.8%）研究专门评估了慢性鼻-鼻窦炎（CRS），其中 5 篇 CRS 研究表明 CRS 与 SHS 之间存在显著关联。17 篇文章为病例对照研究（3b 级）。在表征鼻窦炎方面，6 项（31.6%）研究将 CT 或内镜纳入诊断标准，其中 5 项研究遵循鼻窦炎工作组指南。为了确定 SHS 的存在，所有研究均使用问卷，其中 2 项（10.5%）研究还报告了血清或尿液可替宁水平。
本系统评价纳入的大多数研究（68.4%）显示鼻窦炎与 SHS 之间存在显著关联。此外，6 项具有客观诊断标准（CT、内镜）的研究中有 5 项（83.3%）发现鼻窦炎与 SHS 之间存在显著关联。未来应进行更多具有客观诊断鼻窦炎和量化 SHS 暴露的高质量研究，以更好地评估鼻窦炎与 SHS 之间的关系。
