1 Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
2 Department of Neurosurgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Otolaryngol Head Neck Surg. 2019 Jun;160(6):1118-1123. doi: 10.1177/0194599819838761. Epub 2019 Mar 26.
Examine outcomes of septoplasty with turbinate reductions in patients with allergic rhinitis as compared to patients without allergic rhinitis using validated outcome and quality-of-life (QOL) instruments.
Prospective observational cohort study.
Single surgeon, university hospital.
Consecutive study-eligible patients with a symptomatic nasal septal deviation, with (n = 30) or without (n = 30) documented allergic rhinitis, were enrolled from March 2014 to February 2017. All patients subsequently underwent nasal septoplasty and inferior turbinate reductions. Outcomes were studied using the Nasal Obstruction Symptom Evaluation (NOSE) scale, mini-Rhinoconjunctivitis Quality of Life Questionnaire (mini-RQLQ), and Ease-of-Breathing (EOB) Likert scores completed preoperatively and, together with a patient satisfaction Likert, at 3 and 6 months postoperatively.
NOSE scores, EOB scores, and mini-RQLQ scores improved significantly in both groups at 3 and 6 months postoperatively. Results were sustained from 3 to 6 months. Although mini-RQLQ scores in allergic patients were higher at all intervals, the magnitude of change in scores in both groups was comparable.
Although patients with allergic rhinitis report greater allergy-related QOL impairment (mini-RQLQ) on a day-to-day basis than nonallergic patients, this does not appear to attenuate the benefit they might experience from septoplasty and turbinate reductions when indicated for nasal obstruction. Furthermore, the symptomatic relief of their structural nasal obstruction appears to significantly improve their overall allergy-related quality of life. If appropriate expectations are set pre-operatively, allergic rhinitis is neither a contraindication nor a deterrent to septoplasty and turbinate reductions and these patients can reasonably expect a high degree of satisfaction post-operatively.
使用经过验证的结局和生活质量(QOL)工具,比较伴或不伴变应性鼻炎的鼻中隔偏曲患者鼻中隔成形术的结局。
前瞻性观察队列研究。
单外科医生,大学医院。
2014 年 3 月至 2017 年 2 月,连续符合研究条件的有症状鼻中隔偏曲患者(伴变应性鼻炎患者,n=30;不伴变应性鼻炎患者,n=30)纳入研究。所有患者随后接受鼻中隔成形术和下鼻甲切除术。使用鼻腔阻塞症状评估量表(NOSE)、迷你鼻结膜炎生活质量问卷(mini-RQLQ)和呼吸困难量表(EOB)进行研究,在术前和术后 3 个月和 6 个月进行,并使用患者满意度量表进行评分。
两组患者在术后 3 个月和 6 个月时 NOSE 评分、EOB 评分和 mini-RQLQ 评分均显著改善,并且在 3 个月至 6 个月间保持稳定。尽管变应性患者在所有时间点的 mini-RQLQ 评分均较高,但两组的评分变化幅度相当。
尽管变应性鼻炎患者在日常生活中报告的与过敏相关的 QOL 损害(mini-RQLQ)更高,但这似乎并不会减弱鼻中隔偏曲和鼻甲切除术对他们因鼻塞而受益的程度。此外,他们结构性鼻塞的症状缓解显著改善了他们整体的与过敏相关的生活质量。如果在术前设定适当的预期,变应性鼻炎既不是鼻中隔偏曲和鼻甲切除术的禁忌证,也不是手术的障碍,这些患者可以合理地期望术后有很高的满意度。