Arslan Fatih, Tasdemir Serdar, Durmaz Abdullah, Tosun Fuat
Department of Otolaryngology, Head and Neck Surgery, Beytepe Murat Erdi Eker State Hospital, Ankara, Turkey.
Department of Neurology, Beytepe Murat Erdi Eker State Hospital, Ankara, Turkey.
Cogn Neurodyn. 2018 Aug;12(4):385-390. doi: 10.1007/s11571-018-9482-4. Epub 2018 Mar 2.
Chronic rhinosinusitis with nasal polyposis is a chronic inflammatory disease of the respiratory mucosa of the nasal cavity and paranasal sinuses. The aim of this study was investigate the effect of nasal obstruction related to chronic rhinosinusitis with nasal polyposis on cognitive functions. Patients with chronic rhinosinusitis with nasal polyposis causing bilateral total or near total nasal obstruction were enrolled in the study. Symptoms of nasal congestion, loss of smell, postnasal drip, headaches, snoring, concentration difficulties and blunted affect were evaluated by Visual Analog Scale. Brief symptom inventory test, Stroop test, visual aural digit span, serial digit learning test and P300 test were used to evaluate cognitive functions. Three months after treatment, the tests done before surgery were repeated and the results were compared. A total of 30 patients were included in the study. On the Visual Analog Scale, all symptoms showed significant postoperative improvement in all patients ( < 0.001 for all symptoms). Preoperative nasal congestion accompanied with impaired concentration were detected in 27 patients (90%), and these symptoms recovered in all these patients after treatment ( = 0.035) (correlation coefficient 0.4). Only 22 patients completed the neuropsychological tests. The mean preoperative Stroop test (23.16 ± 5.30), visual aural digit span test (24.68 ± 3.52), and serial digit learning test (16.18 ± 5.35) scores were showed significant improvement compared with mean postoperative Stroop test (21.12 ± 5.69), visual aural digit span test (26.45 ± 2.98), and serial digit learning test (19.31 ± 4.47) scores ( = 0.047, = 0.022, = 0.005 respectively). The postoperative P300 latency values improved in 19 (63%) patients. The preoperative and postoperative latency values for P300 showed a significant difference ( = 0.029), whereas the preoperative and postoperative amplitude values for P300 did not differ ( = 0.096). In conclusion, the results of this study indicate that chronic rhinosinusitis with nasal polyposis (CRSwNP) has negative effects on cognitive functions, such as the ability to focus and maintain concentration. These cognitive functions improve after the patients undergo endoscopic sinus surgery to treat their CRSwNP.
伴有鼻息肉的慢性鼻窦炎是鼻腔和鼻窦呼吸黏膜的一种慢性炎症性疾病。本研究的目的是探讨伴有鼻息肉的慢性鼻窦炎所致鼻阻塞对认知功能的影响。纳入伴有鼻息肉的慢性鼻窦炎导致双侧完全或近乎完全鼻阻塞的患者。通过视觉模拟量表评估鼻塞、嗅觉减退、鼻后滴漏、头痛、打鼾、注意力不集中和情感迟钝等症状。使用简明症状量表测试、斯特鲁普测试、视觉听觉数字广度测试、连续数字学习测试和P300测试来评估认知功能。治疗3个月后，重复术前进行的测试并比较结果。本研究共纳入30例患者。在视觉模拟量表上，所有患者的所有症状术后均有显著改善（所有症状P<0.001）。27例患者（90%）术前存在鼻塞伴注意力受损，治疗后所有这些患者的这些症状均恢复（P=0.035）（相关系数0.4）。仅22例患者完成了神经心理学测试。术前斯特鲁普测试（23.16±5.30）、视觉听觉数字广度测试（24.68±3.52）和连续数字学习测试（16.18±5.35）的平均得分与术后斯特鲁普测试（21.12±5.69）、视觉听觉数字广度测试（26.45±2.98）和连续数字学习测试（19.31±4.47）的平均得分相比有显著改善（分别为P=0.047、P=0.022、P=0.005）。19例（63%）患者术后P300潜伏期值改善。术前和术后P300潜伏期值有显著差异（P=0.029），而术前和术后P300波幅值无差异（P=0.096）。总之，本研究结果表明，伴有鼻息肉的慢性鼻窦炎（CRSwNP）对认知功能有负面影响，如注意力集中和维持注意力的能力。患者接受内镜鼻窦手术治疗CRSwNP后，这些认知功能得到改善。
