Division of Endoscopic Sinus and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, OR.
Int Forum Allergy Rhinol. 2019 Aug;9(8):926-933. doi: 10.1002/alr.22356. Epub 2019 Jun 20.
The impact on quality of life (QoL) of bilateral inferior turbinate reduction (BITR) performed in the setting of endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS) has been a point of controversy. The aim of this study was to determine whether addition of BITR to ESS is associated with improved QoL when compared with ESS alone.
This study presented findings a multi-institutional, retrospective analysis of a prospective open cohort of patients electing ESS for failed medical management of CRS. QoL parameters were compared between patients who underwent ESS alone vs those who underwent ESS with BITR.
A total of 571 patients with CRS who elected to undergo ESS were identified. Sixty-one of these patients also underwent concurrent BITR, whereas 510 patients underwent ESS without BITR. Mean length of follow-up was 15.1 months. Comparison between baseline and last postoperative QoL, olfaction, and endoscopic scores revealed significant improvement in both groups. Overall, BITR surgery was not significantly associated with clinically significant incremental improvement in QoL in either the polyp or non-polyp group. Nevertheless, statistically significant improvement was noted for the nasal congestion/blockage symptom in polyp patients (p = 0.006) and in primary surgery patients (p = 0.027) who underwent BITR.
BITR in the setting of ESS for CRS is not associated with significant incremental improvement in overall QoL vs ESS alone. However, BITR in polyp and primary surgery patients undergoing ESS appears to offer a significant incremental improvement in nasal congestion/blockage symptoms compared with ESS alone. Future studies are warranted to better corroborate these findings.
在内窥镜鼻窦手术(ESS)治疗慢性鼻-鼻窦炎(CRS)中进行双侧下鼻甲缩小(BITR)对生活质量(QoL)的影响一直存在争议。本研究旨在确定与单独进行 ESS 相比,在 ESS 中添加 BITR 是否与 QoL 的改善相关。
本研究为多机构、前瞻性开放队列研究的回顾性分析,纳入了因 CRS 经药物治疗失败而选择 ESS 的患者。比较了单独接受 ESS 治疗的患者与同时接受 ESS 和 BITR 治疗的患者的 QoL 参数。
共确定了 571 例选择 ESS 治疗 CRS 的患者。其中 61 例患者同时进行了 BITR,510 例患者仅进行了 ESS。平均随访时间为 15.1 个月。两组患者的基线和最后一次术后 QoL、嗅觉和内镜评分比较均显示显著改善。总体而言,BITR 手术与单独进行 ESS 相比,在息肉或非息肉组中均未显著增加 QoL 的临床显著改善。然而,BITR 手术显著改善了息肉患者的鼻塞/阻塞症状(p = 0.006)和初次手术患者的鼻塞/阻塞症状(p = 0.027)。
在 ESS 治疗 CRS 中进行 BITR 与单独进行 ESS 相比,并未显著增加总体 QoL 的改善。然而,对于接受 ESS 的息肉和初次手术患者,BITR 似乎可显著改善鼻塞/阻塞症状,与单独进行 ESS 相比。需要进一步的研究来更好地证实这些发现。