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门诊鼻科学的实践模式:美国鼻科学会调查

Practice Patterns in Office-Based Rhinology: Survey of the American Rhinologic Society.

作者信息

Lee Jivianne T, DelGaudio John, Orlandi Richard R

机构信息

1 Department of Head & Neck Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California.

2 Department of Otolaryngology-Head & Neck Surgery, Emory University School of Medicine, Atlanta, Georgia.

出版信息

Am J Rhinol Allergy. 2019 Jan;33(1):26-35. doi: 10.1177/1945892418804904. Epub 2018 Oct 11.

Abstract

BACKGROUND

Recent years have witnessed significant expansion in office-based rhinology. This study assesses practice patterns of the American Rhinologic Society (ARS) membership regarding office-based rhinologic procedures.

METHODS

A 24-item survey was disseminated to the ARS membership from March 15 to May 31, 2016.

RESULTS

A total of 157 physicians (11.9%) completed the survey. Office-based rhinologic procedures were performed by 99% of respondents, with sinonasal debridements (99%), polypectomy (77%), and balloon sinus ostial dilation (56%) being the most common. During a typical month, the number of sinonasal debridements was 0-10 in 23%, 11-20 in 34%, 21-30 in 26%, and >30 in 18%. For polypectomy, 57% of the respondents utilized a microdebrider (reusable electric-24%, disposable vacuum-powered-21%, and both-12%), 36% endoscopic forceps, and 7% a combination of both. With respect to balloon ostial dilation, the frontal sinuses were the most frequently addressed (53%) followed by the maxillary (46%) and sphenoid (39%) sinuses. In-office ethmoidectomies, antrostomies, sphenoidotomies, and frontal sinusotomies without the use of the balloon were performed by 35%, 31%, 24%, and 21% of the respondents, respectively. Thirty percent of respondents used steroid-eluting sinus implants and 10% used computer-assisted surgical navigation in the office setting. Overall, 63% of respondents reported that the number of office-based rhinologic procedures they performed had increased over the last 5 years.

CONCLUSIONS

The present study illustrates the integration of office procedures into rhinologic clinical practice among ARS survey respondents. With ongoing technologic innovations, the scope of office-based rhinology will likely continue to expand in the years to come.

摘要

背景

近年来,门诊鼻科学有了显著发展。本研究评估了美国鼻科学会(ARS)会员在门诊鼻科手术方面的实践模式。

方法

2016年3月15日至5月31日向ARS会员发放了一份包含24个项目的调查问卷。

结果

共有157名医生(11.9%)完成了调查。99%的受访者进行过门诊鼻科手术,其中鼻窦清创术(99%)、息肉切除术(77%)和球囊鼻窦开口扩张术(56%)最为常见。在一个典型的月份里,23%的受访者进行鼻窦清创术的次数为0至10次,34%为11至20次,26%为21至30次,18%超过30次。对于息肉切除术,57%的受访者使用微型切割器(可重复使用的电动型占24%,一次性真空动力型占21%,两者皆用的占12%),36%使用内镜钳,7%两者结合使用。关于球囊开口扩张术,最常处理的是额窦(53%),其次是上颌窦(46%)和蝶窦(39%)。分别有35%、31%、24%和21%的受访者在门诊进行不使用球囊的筛窦切除术、上颌窦造口术、蝶窦切开术和额窦切开术。30%的受访者在门诊使用类固醇洗脱鼻窦植入物,10%使用计算机辅助手术导航。总体而言,63%的受访者表示他们在过去5年中进行的门诊鼻科手术数量有所增加。

结论

本研究表明,在接受ARS调查的受访者中,门诊手术已融入鼻科临床实践。随着技术的不断创新,未来几年门诊鼻科学的范围可能会继续扩大。

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