Xu Jun, Park Sung Je, Park Hee Sung, Han Ruining, Rha Ki-Sang, Kim Yong Min
Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Korea.
Yanbian University Hospital, Yanji, Jilin, China.
Eur Arch Otorhinolaryngol. 2016 Dec;273(12):4351-4357. doi: 10.1007/s00405-016-4185-0. Epub 2016 Jun 30.
The aim of this study was to compare the effects of triamcinolone (TA)- and saline-soaked biodegradable nasal dressing on subjective symptoms, wound healing and improvement of olfactory dysfunction in patients with chronic rhinosinusitis with nasal polyposis (CRSwNP) after undergoing endoscopic sinus surgery (ESS). The study was a prospective, randomized, double-blinded, placebo-controlled study. A total of 80 patients undergoing bilateral ESS for CRSwNP were enrolled and randomly assigned to two groups. Nasal dressing was impregnated with normal saline in the control group, while patients received triamcinolone-impregnated dressing in the TA group. Sino-Nasal Outcome Test 20 (SNOT-20) and Korean Version of the Sniffin' Stick (KVSS) II test were used to assess the patients' condition preoperatively and at postoperative 1 and 3 months. Lund-Kennedy (L-K) and perioperative sinus endoscopy (POSE) scores were assessed on postoperative months 1, 2, and 3. There were significant differences between the control group and the TA group in terms of postoperative L-K scores and POSE scores at 1 and 2 months. The postoperative endoscopic scores were significantly decreased in the TA group compared to the control at 1 month. Olfactory functions were significantly improved at postoperative 3 months (p = 0.0099) compared to the preoperative score in the TA group. Significant improvement in the olfactory functions among anosmic and hyposmic patients at postoperative 1 month (p = 0.0475) and 3 months (p = 0.0019) compared to their preoperative olfactory function score was observed only in the TA group. TA-impregnated dressing had a significant advantage over saline-soaked dressing with regard to postoperative wound healing and improvement of olfactory function.
本研究旨在比较曲安奈德(TA)浸渍和生理盐水浸渍的可生物降解鼻腔敷料对慢性鼻-鼻窦炎伴鼻息肉(CRSwNP)患者在内镜鼻窦手术(ESS)后主观症状、伤口愈合及嗅觉功能障碍改善的影响。该研究为一项前瞻性、随机、双盲、安慰剂对照研究。共有80例因CRSwNP接受双侧ESS的患者入组并随机分为两组。对照组的鼻腔敷料用生理盐水浸渍,而TA组患者接受曲安奈德浸渍的敷料。采用鼻-鼻窦结局测试20(SNOT-20)和韩国版嗅觉棒(KVSS)II测试评估患者术前以及术后1个月和3个月时的情况。在术后第1、2和3个月评估Lund-Kennedy(L-K)和围手术期鼻窦内镜检查(POSE)评分。对照组和TA组在术后1个月和2个月时的L-K评分和POSE评分存在显著差异。与对照组相比,TA组术后1个月时的内镜评分显著降低。与术前评分相比,TA组术后3个月时嗅觉功能显著改善(p = 0.0099)。仅在TA组中观察到嗅觉减退和嗅觉缺失患者术后1个月(p = 0.0475)和3个月(p = 0.0019)时的嗅觉功能较术前嗅觉功能评分有显著改善。在术后伤口愈合和嗅觉功能改善方面,曲安奈德浸渍的敷料比生理盐水浸渍的敷料具有显著优势。