慢性鼻-鼻窦炎患者与嗓音相关的生活质量
Voice-Related Quality of Life in Patients with Chronic Rhinosinusitis.
作者信息
Wu Arthur W, Walgama Evan S, Borrelli Michela, Mirocha James, Barbu Anca M, Vardanyan Narine, Shamsian Arash, Hopp Stephanie, Hopp Martin L
机构信息
Cedars-Sinai Division of Otolaryngology-Head & Neck Surgery, Los Angeles, CA, USA.
Cedars-Sinai Biostatistics and Bioinformatics Research Center Los Angeles, CA, USA.
出版信息
Ann Otol Rhinol Laryngol. 2020 Oct;129(10):983-987. doi: 10.1177/0003489420924061. Epub 2020 May 26.
OBJECTIVE
Chronic rhinosinusitis (CRS) has long been associated with vocal dysfunction. However, studies quantifying the presence of voice dysfunction in CRS patients or the effects of functional endoscopic sinus surgery (FESS) are sparse. The goal of this study was to determine the voice-related quality of life in patients undergoing FESS for CRS using the validated Voice Related Quality of Life Survey (VRQL). We correlated the preoperative VRQL scores to the Sino-Nasal Outcome Test (SNOT-22) scores, and we determined the effect of FESS on postoperative VRQL scores.
METHODS
Consecutive patients undergoing FESS were preoperatively administered both the VRQL and the SNOT-22 surveys. Spearman (ρ) and Pearson () correlation coefficients were calculated. The VRQL was mailed to patients postoperatively between 3 and 6 months. The paired t-test was used to compare pre- and post-FESS scores.
RESULTS
A total of 102 patients were enrolled, and 81 patients completed the two surveys. A total of 51 (62.9%) patients had raw VRQL score ≥ 10, signifying presence of significant vocal symptoms. The mean ± standard deviation (SD) raw VRQL score of the entire study population was 12.4 ± 4.6, and the mean SNOT-22 score was 37.8 ± 19.2. The Spearman correlation coefficient between VRQL and the total SNOT-22 score was 0.34 ( =.002), and the Pearson correlation coefficient was 0.36 ( = .001). Both correlations were similar, demonstrating that increasing severity of CRS symptoms correlates with decreasing voice-related quality of life (QOL). Seventy patients completed the postoperative survey for an 86% retention rate. Thirty-six of these patients had abnormal preoperative VRQL scores, and these patients improved significantly after FESS. The mean preoperative versus postoperative raw scores were 15.2 ± 5.6 versus 12.5 ± 4.1, respectively ( = .003).
CONCLUSION
This study demonstrates the increasing presence of vocal complaints with increasing severity of CRS. It also demonstrates that VRQL scores improve after FESS in those patients with preoperative vocal complaints.
LEVEL OF EVIDENCE
IV.
目的
慢性鼻-鼻窦炎（CRS）长期以来一直与嗓音功能障碍相关。然而，量化CRS患者嗓音功能障碍的存在情况或功能性鼻内镜鼻窦手术（FESS）效果的研究较少。本研究的目的是使用经过验证的嗓音相关生活质量调查问卷（VRQL）来确定接受FESS治疗CRS患者的嗓音相关生活质量。我们将术前VRQL评分与鼻窦结局测试（SNOT-22）评分进行关联，并确定FESS对术后VRQL评分的影响。
方法
对连续接受FESS的患者术前进行VRQL和SNOT-22调查。计算Spearman（ρ）和Pearson（）相关系数。术后3至6个月将VRQL邮寄给患者。采用配对t检验比较FESS术前和术后评分。
结果
共纳入102例患者，81例患者完成了两项调查。共有51例（62.9%）患者的VRQL原始评分≥10，表明存在明显的嗓音症状。整个研究人群的VRQL原始评分的平均值±标准差（SD）为12.4±4.6，SNOT-22评分的平均值为37.8±19.2。VRQL与SNOT-22总分之间的Spearman相关系数为0.34（P =.002），Pearson相关系数为0.36（P =.001）。两种相关性相似，表明CRS症状严重程度增加与嗓音相关生活质量（QOL）下降相关。70例患者完成了术后调查，保留率为86%。其中36例患者术前VRQL评分异常，这些患者在FESS后有显著改善。术前与术后原始评分的平均值分别为15.2±5.6和12.5±4.1（P =.003）。
结论
本研究表明，随着CRS严重程度的增加，嗓音主诉越来越多。它还表明，术前有嗓音主诉的患者在FESS后VRQL评分有所改善。
证据级别
IV级。
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