Koskinen Anni, Salo Riikka, Huhtala Heini, Myller Jyri, Rautiainen Markus, Kääriäinen Janne, Penttilä Matti, Renkonen Risto, Raitiola Hannu, Mäkelä Mika, Toppila-Salmi Sanna
Haartman Institute, University of Helsinki (a.k., r.s., r.r., s.t-s.).
the Department of Otorhinolaryngology (a.k.); University of Helsinki and Helsinki University Hospital.
Laryngoscope Investig Otolaryngol. 2016 Jul 5;1(4):96-105. doi: 10.1002/lio2.27. eCollection 2016 Aug.
Chronic rhinosinusitis (CRS) is a variable multifactorial disease. It can be divided into forms with nasal polyps (CRSwNP) and without (CRSsNP). Sinus and/or nasal polypectomy surgery are considered if maximal conservative treatment is insufficient. The predictive factors of the need of revision surgery comprise mostly the CRSwNP phenotype and are not fully understood.
The aim of this follow-up study was to evaluate the factors associated with the revision surgery rate in CRS patients with variable extent of disease.
Data of CRS patients (N = 178) undergoing sinus surgery and/or nasal polypectomy in 2001 to 2010 were used. Patient characteristics and follow-up data were collected from patient records and questionnaires. Associations were analyzed by Fisher's exact, Mann Whitney U, and the Kaplan-Meier method with log-rank test. Unadjusted Cox's proportional hazard models were used for 12 variables and were fitted for the need for revision sinus surgery and/or nasal polypectomy during follow-up of in average 9 years.
The proportion of CRS patients who had undergone revision in 5 years was 9.6%. After adjustment, the following factors associated significantly with the need for recurrent CRS surgery: allergic rhinitis, corticosteroid treatment, previous surgery of CRS, and recurrent NP.
Increased risk of progressive CRS phenotypes with the need for revision surgery would putatively be recognized by relatively simple clinical questions. Further studies with increased sample size are needed to evaluate whether these predictive factors would be relevant for developing better detection and management of progressive CRS.
2b.
慢性鼻-鼻窦炎（CRS）是一种多因素的可变疾病。它可分为伴有鼻息肉的类型（CRSwNP）和不伴有鼻息肉的类型（CRSsNP）。如果最大程度的保守治疗无效，则考虑进行鼻窦和/或鼻息肉切除术。再次手术需求的预测因素主要包括CRSwNP表型，但其尚未完全明确。
这项随访研究的目的是评估疾病程度不同的CRS患者再次手术率的相关因素。
使用2001年至2010年接受鼻窦手术和/或鼻息肉切除术的CRS患者（N = 178）的数据。从患者记录和问卷中收集患者特征和随访数据。采用Fisher精确检验、Mann-Whitney U检验以及带有对数秩检验的Kaplan-Meier方法分析相关性。对12个变量使用未调整的Cox比例风险模型，以拟合平均9年随访期间再次进行鼻窦手术和/或鼻息肉切除术的需求。
5年内接受再次手术的CRS患者比例为9.6%。调整后，以下因素与复发性CRS手术需求显著相关：过敏性鼻炎、皮质类固醇治疗、既往CRS手术史以及复发性鼻息肉。
需要再次手术的进行性CRS表型风险增加可能通过相对简单的临床问题得以识别。需要进一步开展更大样本量的研究，以评估这些预测因素是否与更好地检测和管理进行性CRS相关。
2b。
