Seo Min Young, Nam Do-Hyun, Kong Doo-Sik, Lee Jung Joo, Ryu Gwanghui, Kim Hyo Yeol, Dhong Hun-Jong, Chung Seung-Kyu, Lee Kyung Eun, Hong Sang Duk
Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Korea University Ansan Hospital, Ansan, South Korea.
Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Laryngoscope. 2019 Jun;129(6):1318-1324. doi: 10.1002/lary.27630. Epub 2018 Dec 19.
OBJECTIVES/HYPOTHESIS: The aim of this study was to compare sinonasal-related quality of life (QOL) in patients treated by extended or transsellar endoscopic skull base surgery.
Prospective data analysis.
Prospectively collected data from patients who underwent endoscopic skull base surgery between 2012 and 2017 were analyzed. Primary outcomes were preoperative Sino-Nasal Outcome Test-20 (SNOT-20) scores and then 1-month, 3-month, and 6-month follow-up. Comparative analysis was performed between the endoscopic transsellar approach (ETA) group (n = 647) and an extended endoscopic endonasal approach (EEEA) group (n = 120). In ETA group, the SNOT-20 score was compared between patients with a nasoseptal flap (NSF) (ETA-NSF) and without an NSF (ETA-no NSF).
The mean total SNOT-20 score was significantly worse in the EEEA than ETA group at 1, 3, and 6 months postoperatively (P < .05). Although there was no significant difference in total SNOT-20 score between the ETA-NSF and ETA-no NSF group at 3 and 6 months after surgery, the percentage of patients with significant change (≥0.8) in the SNOT-20 score was higher in the NSF used group at 1, 3, and 6 months postoperatively (22.92% vs. 13.51%, P = .029; 20.59% vs. 5.59%, P = .039; and 24.00% vs. 4.03%, P = .003, respectively). According to multivariate analysis conducted regarding factors that deteriorate sinonasal QOL at 6 months following surgery, only NSF usage is significantly associated with poor outcome (odds ratio: 4.371, P = .011) CONCLUSIONS: Sinonasal-related QOL was significantly worse in patients treated by the EEEA versus ETA. Use of an NSF is the only poor prognostic factor in sinonasal QOL after endoscopic skull base surgery.
2b Laryngoscope, 129:1318-1324, 2019.
目的/假设：本研究旨在比较接受扩大或经蝶窦内镜颅底手术患者的鼻窦相关生活质量（QOL）。
前瞻性数据分析。
对2012年至2017年间接受内镜颅底手术患者的前瞻性收集数据进行分析。主要结局指标为术前鼻窦结局测试-20（SNOT-20）评分，以及术后1个月、3个月和6个月的随访评分。在内镜经蝶窦入路（ETA）组（n = 647）和扩大内镜鼻内入路（EEEA）组（n = 120）之间进行比较分析。在ETA组中，比较了使用鼻中隔瓣（NSF）的患者（ETA-NSF）和未使用NSF的患者（ETA-无NSF）的SNOT-20评分。
术后1个月、3个月和6个月时，EEEA组的平均SNOT-20总分显著低于ETA组（P <.05）。虽然术后3个月和6个月时，ETA-NSF组和ETA-无NSF组的SNOT-20总分无显著差异，但术后1个月、3个月和6个月时，使用NSF组的SNOT-20评分有显著变化（≥0.8）的患者百分比更高（分别为22.92%对13.51%，P =.029；20.59%对5.59%，P =.039；24.00%对4.03%，P =.003）。根据对术后6个月时导致鼻窦QOL恶化的因素进行的多变量分析，只有NSF的使用与不良结局显著相关（优势比：4.371，P =.011）。结论：与ETA相比，接受EEEA治疗的患者鼻窦相关QOL显著更差。使用NSF是内镜颅底手术后鼻窦QOL的唯一不良预后因素。
2b《喉镜》，129:第1318 - 1324页，2019年。
