Taylor Robert J, Miller Justin D, Rose Austin S, Drake Amelia F, Zdanski Carlton J, Senior Brent A, Ebert Charles S, Zanation Adam M
Rhinology. 2014 Dec;52(4):327-33. doi: 10.4193/Rhino14.028.
Limited quality of life data exist for pediatric chronic rhinosinusitis (CRS) patients undergoing endoscopic sinus surgery (ESS). Further exploration of the following areas will enhance understanding and support clinical decision-making: baseline and post-ESS general and disease-specific quality of life, parent vs. child report, and correlation of nasal endoscopy to sinus CT scores.
A prospective cohort study evaluated CRS patients age 5-18 undergoing ESS. Surveys were completed at two timepoints: (1) pre-ESS and (2) 30-90 days post-ESS, with parents completing general (PedsQLTM) and CRS-specific (SNOT-16 and SN-5) quality of life surveys and children completing PedsQLTM and SNOT-16 surveys. Preoperative Lund-Kennedy nasal endoscopy and Lund-Mackay sinus CT scores were calculated. Where appropriate, outcomes were stratified by cystic fibrosis status.
Impaired preoperative general quality of life was evidenced by parent proxy-report of PedsQLTM scores in 10 cystic fibrosis and 11 non-CF patients. ESS was associated with decreased sinus symptoms at 1-3 months postoperatively with SN-5 change scores of -1.85 and -2.2, in CF and non-CF patients, respectively. Parents reported worse CRS symptoms via higher preoperative SNOT-16 scores than their children did. Nasal endoscopy and sinus CT scores correlated with a Spearman correlation coefficient of 0.51. Scores not reaching statistical significance included CF-related CRS SNOT-16 change scores and PedsQLTM general quality of life change scores.
In pediatric patients with CRS electing ESS, general quality of life is impaired preoperatively and sinus symptoms improve significantly 1-3 months after sinus surgery. Parents report statistically worse CRS symptom scores than their children do. Nasal endoscopy scores in this cohort correlated with sinus CT scores.
接受鼻内镜鼻窦手术（ESS）的小儿慢性鼻-鼻窦炎（CRS）患者的生活质量数据有限。对以下领域的进一步探索将增进理解并支持临床决策：ESS术前及术后的总体和疾病特异性生活质量、家长与患儿报告的差异，以及鼻内镜检查结果与鼻窦CT评分的相关性。
一项前瞻性队列研究评估了5至18岁接受ESS的CRS患者。在两个时间点完成问卷调查：（1）ESS术前；（2）ESS术后30至90天，家长完成总体（儿童生活质量量表）和CRS特异性（鼻窦疾病特异性量表-16和鼻窦疾病特异性量表-5）生活质量调查问卷，患儿完成儿童生活质量量表和鼻窦疾病特异性量表-16调查问卷。计算术前的伦德-肯尼迪鼻内镜评分和伦德-麦凯鼻窦CT评分。在适当情况下，根据囊性纤维化状态对结果进行分层。
10例囊性纤维化患者和11例非囊性纤维化患者的家长通过代理报告儿童生活质量量表评分，证明术前总体生活质量受损。ESS与术后1至3个月鼻窦症状减轻相关，囊性纤维化患者和非囊性纤维化患者的鼻窦疾病特异性量表-5变化评分分别为-1.85和-2.2。家长报告的术前鼻窦疾病特异性量表-16评分显示CRS症状比患儿更严重。鼻内镜检查和鼻窦CT评分的Spearman相关系数为0.51。未达到统计学显著性的评分包括与囊性纤维化相关的CRS鼻窦疾病特异性量表-16变化评分和儿童生活质量量表总体生活质量变化评分。
在选择ESS的小儿CRS患者中，术前总体生活质量受损，鼻窦手术后1至3个月鼻窦症状明显改善。家长报告的CRS症状评分在统计学上比患儿更严重。该队列中的鼻内镜检查评分与鼻窦CT评分相关。
