Yelverton Joshua C, Jackson Peter, Schmidt Robert S
MD, Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University Health System, PO Box 980146, Richmond, VA 23298, USA.
Ear Nose Throat J. 2014 Sep;93(9):E26-8. doi: 10.1177/014556131409300906.
Midface fractures commonly occur following trauma to the face and may cause changes in the normal sinus outflow system. To the best of our knowledge, no study has examined the incidence of rhinosinusitis following midface fractures. We report the incidence of chronic rhinosinusitis in patients who underwent surgical repair of a midface fracture. Our evaluation tool was the 20-item Sino-Nasal Outcome Test quality-of-life survey (SNOT-20). We mailed a demographic survey and the SNOT-20 questionnaire to 486 eligible patients who had undergone surgical repair of either a midface (n = 234) or mandible (n = 252) fracture; we had intended to use the latter cohort as a control group. Of the 234 midface patients, 34 (14.5%) returned a usable survey, but only 7 of the 252 mandibular patients (2.8%) did so, which was not a sufficient number for analysis; therefore we used normative data obtained from another study for comparison purposes. The mean SNOT-20 score in our cohort was 24.15, which was similar to the 28.7 mean score in the control cohort of patients with rhinosinusitis. The highest mean scores for the individual components of the SNOT-20 were for "Wake up at night," "Lack of a good night's sleep," "Wake up tired," and "Frustrated/restless/irritable." The components that the most patients found bothersome were "Facial pain/pressure," "Need to blow nose," "Runny nose," and "Lack of a good night's sleep." We conclude that patients who experience a midface fracture have a much higher risk of developing chronic rhinosinusitis that negatively affects their long-term quality of life. These patients should be monitored with long-term follow-up and treated appropriately.
面中部骨折常见于面部受外伤后，可能导致正常鼻窦引流系统发生改变。据我们所知，尚无研究调查面中部骨折后鼻窦炎的发病率。我们报告了接受面中部骨折手术修复患者的慢性鼻窦炎发病率。我们的评估工具是20项鼻-鼻窦结局测试生活质量调查问卷（SNOT-20）。我们向486名符合条件的患者邮寄了一份人口统计学调查问卷和SNOT-20问卷，这些患者均接受了面中部（n = 234）或下颌骨（n = 252）骨折的手术修复；我们本打算将后一组作为对照组。在234名面中部骨折患者中，34名（14.5%）返回了可用的调查问卷，但252名下颌骨骨折患者中只有7名（2.8%）返回了问卷，这一数量不足以进行分析；因此，我们使用了从另一项研究中获得的标准数据进行比较。我们队列中的SNOT-20平均得分是24.15，这与鼻窦炎对照组患者的平均得分28.7相似。SNOT-20各个组成部分的最高平均得分是“夜间醒来”“睡眠不佳”“醒来疲惫”和“沮丧/烦躁/易怒”。大多数患者认为最困扰的组成部分是“面部疼痛/压痛”“需要擤鼻涕”“流鼻涕”和“睡眠不佳”。我们得出结论，经历面中部骨折的患者发生慢性鼻窦炎的风险要高得多，这会对他们的长期生活质量产生负面影响。这些患者应接受长期随访监测并进行适当治疗。
