Koskinen Anni, Myller Jyri, Mattila Petri, Penttilä Matti, Silvola Juha, Alastalo Ismo, Huhtala Heini, Hytönen Maija, Toppila-Salmi Sanna
a Haartman Institute, University of Helsinki , Finland ;
b Department of Otorhinolaryngology , University of Helsinki and Helsinki University Hospital , Finland ;
Acta Otolaryngol. 2016;136(5):532-6. doi: 10.3109/00016489.2015.1129553. Epub 2016 Feb 5.
This is the first controlled study of balloon sinuplasty's long-term efficacy with the follow-up time over 5 years. The results are in accordance with a previous 2-year-follow-up study. Both techniques retained the efficacy and patient satisfaction on average 6 years after the surgery.
Endoscopic sinus surgery (ESS) and balloon sinuplasty are considered as a treatment for chronic rhinosinusitis (CRS) after a failure of conservative therapy. High cost and lack of long-term follow-up studies restrain the use of balloon sinuplasty.
The aim of this study was to compare long-term efficacy and satisfaction in CRS patients who had undergone maxillary sinus operation with either balloon sinuplasty or ESS technique. Previous or additional sinonasal operations were exclusion criteria.
Study patients were recruited from 208 CRS-patients who underwent either ESS or balloon sinuplasty. Patients with nasal polyposis (gradus ≥ 2), previous sinonasal surgery, unilateral disease, or immune deficiency were excluded. Altogether 45 patients in the ESS group and 40 patients in the balloon group were included. Of these, 30 and 28, respectively, answered to a phone interview held on average 6 years after primary surgery. Symptom reduction and long-term satisfaction were evaluated by using symptom scores of 19 parameters altogether.
Both groups experienced improvement in symptoms and were equally satisfied with the operation. The number of patient-reported acute exacerbations was higher among the balloon dilated patients. Also, the reduction of thick nasal discharge was less evident in the balloon sinuplasty group. Four patients in the balloon sinuplasty group underwent revision surgery. There were no revisions in the ESS group.
这是第一项随访时间超过5年的关于球囊鼻窦成形术长期疗效的对照研究。结果与之前一项为期2年的随访研究一致。两种技术在手术后平均6年都保持了疗效和患者满意度。
在内科保守治疗失败后，内镜鼻窦手术（ESS）和球囊鼻窦成形术被视为慢性鼻窦炎（CRS）的治疗方法。高成本和缺乏长期随访研究限制了球囊鼻窦成形术的应用。
本研究旨在比较接受上颌窦手术的CRS患者采用球囊鼻窦成形术或ESS技术后的长期疗效和满意度。既往有鼻窦手术史或额外鼻窦手术史为排除标准。
研究对象从208例行ESS或球囊鼻窦成形术的CRS患者中招募。排除患有鼻息肉（分级≥2级）、既往有鼻窦手术史、单侧疾病或免疫缺陷的患者。ESS组共纳入45例患者，球囊组共纳入40例患者。其中，分别有30例和28例患者在初次手术后平均6年接受了电话随访。通过总共19项参数的症状评分评估症状减轻情况和长期满意度。
两组患者症状均有改善，对手术的满意度相同。球囊扩张组患者报告的急性加重次数更多。此外，球囊鼻窦成形术组鼻分泌物变稠的减轻不太明显。球囊鼻窦成形术组有4例患者接受了翻修手术。ESS组无翻修病例。
