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功能性内窥镜鼻窦手术可改善患有慢性鼻窦炎伴鼻息肉儿童的生活质量。

Functional endoscopic sinus surgery improves the quality of life in children suffering from chronic rhinosinusitis with nasal polyps.

作者信息

Fetta Melina, Tsilis Nikolaos S, Segas John V, Nikolopoulos Thomas P, Vlastarakos Petros V

机构信息

ENT Dept., Ag. Sofia Children's Hospital, Athens, Greece.

ENT Dept., Attikon University Hospital, Athens, Greece.

出版信息

Int J Pediatr Otorhinolaryngol. 2017 Sep;100:145-148. doi: 10.1016/j.ijporl.2017.06.007. Epub 2017 Jun 15.

Abstract

OBJECTIVE

To evaluate the impact of FESS in children with chronic rhinosinusitis with nasal polyps, regarding their overall postoperative quality-of-life (QoL) and constituent QoL domains. Potential differences between cystic fibrosis (CF) sufferers and non-sufferers, or cases with recurrent sinonasal polyposis versus single-operations were also explored.

METHODS

39 children were studied. The mean patient age was 10.9 years; four children suffered from cystic fibrosis. The children (or parents) completed the Glasgow Benefit Inventory for Children (GCBI) at least six months after their operation. The Mann-Whitney test compared the GCBI scores between non- and CF sufferers, as well as children with and without recurrent polyposis.

RESULTS

The median overall QoL score was 98. There were no statistically significant differences between CF sufferers and non-sufferers regarding their overall QoL, or the respective individual QoL domains, apart from their physical postoperative activity (p = 0.04). Twelve children demonstrated recurrent polyposis (30.7%); among them three were cystic fibrosis sufferers. No statistically significant differences were identified in the overall QoL score, or individual GCBI subscale scores between children with recurrent polyposis versus single-operations. Children with recurrent polyposis but not CF performed better regarding their overall QoL (p = 0.021) and medical status (p = 0.015), compared to their CF counterparts.

CONCLUSION

FESS performed for chronic rhinosinusitis with nasal polyps in children is associated with improved postoperative QoL, irrespective of the presence of CF (although the latter needs to be confirmed in larger patient cohorts). The absence of appreciable differences in the overall QoL, or its constituent domains, between single and re-operated children, indicate that the positive effect of FESS outweighed the burden of re-operation. Appropriate preoperative informed consent in cases of recurrent sinonasal polyposis necessitates acknowledging worse respective outcomes in CF sufferers.

摘要

目的

评估功能性鼻内镜鼻窦手术(FESS)对患有慢性鼻窦炎伴鼻息肉儿童的总体术后生活质量(QoL)及其组成的生活质量领域的影响。还探讨了囊性纤维化(CF)患者与非患者之间,或复发性鼻息肉病患者与单次手术患者之间的潜在差异。

方法

对39名儿童进行了研究。患者平均年龄为10.9岁;4名儿童患有囊性纤维化。儿童(或其父母)在手术后至少6个月完成了儿童格拉斯哥获益量表(GCBI)。采用曼-惠特尼检验比较了非CF患者与CF患者之间,以及有和无复发性息肉病儿童之间的GCBI评分。

结果

总体生活质量评分中位数为98。CF患者与非患者在总体生活质量或各自的个体生活质量领域方面,除了术后身体活动外(p = 0.04),没有统计学上的显著差异。12名儿童表现出复发性息肉病(30.7%);其中3名是囊性纤维化患者。在复发性息肉病儿童与单次手术儿童之间,总体生活质量评分或GCBI各子量表评分没有发现统计学上的显著差异。与CF患者相比,有复发性息肉病但无CF的儿童在总体生活质量(p = 0.021)和健康状况(p = 0.015)方面表现更好。

结论

儿童慢性鼻窦炎伴鼻息肉行FESS与术后生活质量改善相关,无论是否存在CF(尽管后者需要在更大的患者队列中得到证实)。单次手术和再次手术的儿童在总体生活质量或其组成领域方面没有明显差异,这表明FESS的积极作用超过了再次手术的负担。对于复发性鼻息肉病患者,术前适当的知情同意需要告知CF患者各自较差的预后情况。

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