[Draf III型额窦手术后鼻功能影响的前瞻性研究]

Li Cheng, Huang Qian, Cui Shunjiu, Ye Ting, Huang Zhenxiao, He Fei, Zhou Bing

Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.

Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China. Email:

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2014 Sep;49(9):711-6.

OBJECTIVE

To evaluate the impact of nasal function after Draf III frontal sinus surgery (Draf III) or the modified endoscopic Lothrop procedure (EMLP).

METHODS

It was a prospective study with self-control. The pre-operative clinical data of 30 patients (from 2010 to 2013, Beijing Tongren Hospital) who underwent Draf III surgery, with the testing results of T&T olfactory testing, acoustic rhinometry and rhinomanometry before and 1 year after operation in these patients were collected in this study. All patients complete visual analogue scale (VAS), a telephone follow-up questionnaire of olfactory function used by Wormald and Lund-Kenndy endoscopy score simultaneously with testings above. Most of 30 patients were chronic rhinosinusitis (CRS) with recurrent nasal polyps or systemic risk factors like asthma and aspirin-intolerance, called refractory rhinosinusitis. SPSS 19.0 software was used to analyze the data.

RESULTS

89.3% (25/28) of these patients improved in nasal obstruction 1 year after operation, and the cure rats was 57.1% (16/28, VAS = 0). The level of improvement in nasal obstruction was significantly correlated with pre-operative nasal obstruction severity (r = 0.909, P < 0.01). 76.7% (23/30) improved in olfactory function 1 year after operation in all 30 patients, and 88.2% improved in patients with nasal polyps (CRSwNP). It was also found that olfactory function 1 year after operation was significantly related to Lund-Kennedy endoscopy scores (r = 0.671, P < 0.01), but was not correlated with VAS scores of nasal obstruction (P = 0.349).

CONCLUSION

The Draf III frontal sinus surgery has a significantly positive effect on olfactory and ventilation function post-operatively, especially on refractory rhinosinusitis.

目的

评估Draf III型额窦手术（Draf III）或改良内镜Lothrop手术（EMLP）后鼻腔功能的影响。

方法

这是一项自身对照的前瞻性研究。本研究收集了2010年至2013年在北京同仁医院接受Draf III手术的30例患者的术前临床资料，以及这些患者术前和术后1年的T&T嗅觉测试、鼻声反射和鼻阻力测量的测试结果。所有患者同时完成视觉模拟量表（VAS）、Wormald使用的嗅觉功能电话随访问卷以及Lund-Kennedy内镜评分。30例患者中大多数为慢性鼻窦炎（CRS）伴复发性鼻息肉或哮喘、阿司匹林不耐受等全身危险因素，即难治性鼻窦炎。使用SPSS 19.0软件分析数据。

结果

这些患者中89.3%（25/28）在术后1年鼻塞症状改善，治愈率为57.1%（16/28，VAS = 0）。鼻塞改善程度与术前鼻塞严重程度显著相关（r = 0.909，P < 0.01）。30例患者中76.7%（23/30）在术后1年嗅觉功能改善，鼻息肉患者（CRSwNP）中88.2%改善。还发现术后1年嗅觉功能与Lund-Kennedy内镜评分显著相关（r = 0.671，P < 0.01），但与鼻塞的VAS评分无关（P = 0.349）。