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鼻内镜切除鼻窦及颅底恶性肿瘤后的鼻窦生活质量

Sinonasal quality of life after endoscopic resection of malignant sinonasal and skull base tumors.

作者信息

Glicksman Jordan T, Parasher Arjun K, Brooks Steven G, Workman Alan D, Lambert Justina L, Bergman Jenna E, Palmer James N, Adappa Nithin D

机构信息

Department of Otorhinolaryngology, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.

出版信息

Laryngoscope. 2018 Apr;128(4):789-793. doi: 10.1002/lary.26833. Epub 2017 Sep 2.

Abstract

OBJECTIVES

Improvement in sinonasal quality of life (QoL) following sinus surgery has been well-documented across the literature. To our knowledge, only one series has evaluated long-term QoL in patients undergoing tumor resection, and that study demonstrated no improvement in rhinologic QoL following malignant tumor resection at 2-year follow-up. The objective of the present study was to evaluate QoL in the 2 years following endoscopic malignant tumor resection.

METHODS

A prospective cohort study was performed, including patients with both malignant and benign sinonasal tumors in a tertiary academic medical center. Patients undergoing endoscopic tumor resection who had completed Sinonasal Outcome Test 22 (SNOT-22) questionnaires were included in the cohort. SNOT-22 questionnaires were administered preoperatively and over a 2-year follow-up period at clinic visits. Longitudinal linear mixed-effects regression was used to compare preoperative QoL to QoL over the 2 years following surgery.

RESULTS

Among 145 patients included in this study, 64 had malignant tumors. There was a statistically significant improvement in SNOT-22 score from baseline to 2 years for patients with both malignant tumors (37.0, 95% confidence Interval [CI] 32.0-42.1 at baseline; 26.5 95% CI 20.8-32.2 at 2 years; P < 0.001) and benign tumors (26.5, 95% CI 21.4-30.4 at baseline; 12.9 95% CI 7.6-18.2 at 2 years; P < 0.001).

CONCLUSION

In contrast to previously reported series, in this cohort endoscopic resection of sinonasal tumors appears to be followed by an improvement in QoL, which is sustained over a 2-year period.

LEVEL OF EVIDENCE

2b. Laryngoscope, 128:789-793, 2018.

摘要

目的

鼻窦手术后鼻窦生活质量(QoL)的改善在文献中已有充分记载。据我们所知,仅有一项研究系列评估了接受肿瘤切除术患者的长期生活质量,且该研究表明,在2年随访期时,恶性肿瘤切除术后患者的鼻科生活质量并无改善。本研究的目的是评估内镜下恶性肿瘤切除术后2年内的生活质量。

方法

进行了一项前瞻性队列研究,纳入了一家三级学术医疗中心的恶性和良性鼻窦肿瘤患者。队列中包括完成了鼻窦结局测试22(SNOT - 22)问卷的接受内镜肿瘤切除术的患者。在术前及术后2年的门诊随访期间发放SNOT - 22问卷。采用纵向线性混合效应回归分析比较术前生活质量与术后2年的生活质量。

结果

本研究纳入的145例患者中,64例患有恶性肿瘤。恶性肿瘤患者(基线时SNOT - 22评分为37.0,95%置信区间[CI] 32.0 - 42.1;2年时为26.5,95% CI 20.8 - 32.2;P < 0.001)和良性肿瘤患者(基线时为26.5,95% CI 21.4 - 30.4;2年时为12.9,95% CI 7.6 - 18.2;P < 0.001)的SNOT - 22评分从基线到2年都有统计学上的显著改善。

结论

与先前报道的研究系列不同,在本队列中,鼻窦肿瘤的内镜切除术似乎能使生活质量得到改善,并在2年期间持续保持。

证据级别

2b。《喉镜》,2018年,第128卷,第789 - 793页。

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