Sethi Gyanesh, Chakravarti Arunabha
Department of ENT and Head & Neck Surgery, Lady Hardinge Medical College and Associated Hospitals, Shaheed Bhagat Singh Marg, New Delhi, 110001, India.
Int J Pediatr Otorhinolaryngol. 2016 Nov;90:160-164. doi: 10.1016/j.ijporl.2016.09.005. Epub 2016 Sep 8.
The present study aims to evaluate the role of Endoscopic Sinus Surgery (ESS) in refractory pediatric Chronic Rhinosinusitis (CRS) and to assess the change in quality of life after ESS.
This prospective interventional study included 35 children (aged between 6 and 12 years) of refractory CRS, not responding to 4 weeks of maximal medical therapy attending the pediatric ENT clinic of a tertiary referral centre. Study period was from November 2013 to March 2016. This patient pool underwent Non Contrast Computed Tomography scan (NCCT) paranasal sinuses and diagnostic nasal endoscopy and those fulfilling the requisite inclusion criteria underwent Endoscopic sinus surgery. Global assessment of Rhinosinusitis Symptom severity score and SN-5 quality of life score of the patients was assessed preoperatively and 1 year after the surgery.
91.4% children showed an improvement in the total symptom score with a statistically significant (p value < 0.001) reduction in the mean total score postoperatively. Similarly 91.4% of the children showed an improvement in their quality of life with a statistically significant (p value < 0.001) difference seen in the average SN-5 scores after ESS. No major complications were encountered in any of the cases.
ESS is a safe and effective surgical management for children with CRS refractory to maximal medical therapy leading to an improvement in their quality of life.
本研究旨在评估鼻内镜鼻窦手术(ESS)在难治性小儿慢性鼻-鼻窦炎(CRS)中的作用,并评估ESS术后生活质量的变化。
这项前瞻性干预性研究纳入了35名(年龄在6至12岁之间)难治性CRS儿童,他们在一家三级转诊中心的儿科耳鼻喉科诊所接受了为期4周的最大程度药物治疗但无反应。研究时间为2013年11月至2016年3月。该患者群体接受了鼻窦非增强计算机断层扫描(NCCT)和诊断性鼻内镜检查,那些符合必要纳入标准的患者接受了鼻内镜鼻窦手术。术前及术后1年对患者的鼻-鼻窦炎症状严重程度评分和SN-5生活质量评分进行整体评估。
91.4%的儿童总症状评分有所改善,术后平均总分有统计学意义的降低(p值<0.001)。同样,91.4%的儿童生活质量有所改善,ESS术后平均SN-5评分有统计学意义的差异(p值<0.001)。所有病例均未出现重大并发症。
对于最大程度药物治疗无效的CRS儿童,ESS是一种安全有效的手术治疗方法,可改善其生活质量。