Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA; Department of Otolaryngology, Clinics Hospital, School of Medicine, University of São Paulo, São Paulo, Brazil.
Int Forum Allergy Rhinol. 2015 Jan;5(1):60-5. doi: 10.1002/alr.21407. Epub 2014 Oct 13.
Endoscopic maxillary mega-antrostomy (EMMA) is a revision surgical procedure for recalcitrant maxillary sinusitis in which medical therapy and endoscopic antrostomy have been unsuccessful. In 2008 our group published favorable outcomes of EMMA in 28 patients with relatively short follow-up and nonvalidated outcome measures. This study reports an update of long-term outcomes of this same cohort, as well as outcomes of an interval cohort of 94 patients using validated outcome measures.
Retrospective review was performed for 122 patients (163 sides) who underwent EMMA between 2005 and 2013. For the original 2008 cohort, the original questionnaire from 2008 was readministered by telephone interview. For the interval cohort, preoperative and postoperative SNOT-22 symptom scores and modified Lund-Kennedy endoscopic scores were compared.
The original 2008 cohort of 28 patients, now with a mean follow-up period of 6.9 years, demonstrated sustained improvement of symptoms. The outcomes were statistically comparable to the 2008 study, with 72.4% reporting complete or significant improvement, 27.6% reporting partial improvement, and 0% reporting worsening.
内镜上颌窦扩大造口术（EMMA）是一种针对复发性上颌窦炎的修正性手术，对于那些药物治疗和内镜鼻窦造口术无效的患者尤为适用。2008 年，我们的团队报道了 28 例接受 EMMA 治疗的患者的良好结果，随访时间相对较短，且使用的是未经验证的疗效评估方法。本研究报告了同一队列的长期疗效更新结果，以及使用经过验证的疗效评估方法的 94 例间隔队列的疗效结果。
回顾性分析了 2005 年至 2013 年间接受 EMMA 治疗的 122 例（163 侧）患者的临床资料。对于 2008 年的原始队列，我们通过电话访谈重新评估了 2008 年的原始问卷。对于间隔队列，比较了术前和术后 SNOT-22 症状评分和改良 Lund-Kennedy 内镜评分。
28 例原始队列患者（随访时间平均为 6.9 年）的症状持续改善。结果与 2008 年的研究相比具有统计学可比性，72.4%的患者报告完全或显著改善，27.6%的患者报告部分改善，0%的患者报告恶化。
