Pendolino Alfonso Luca, Unadkat Samit, Zhang Henry, Pendolino Monica, Bianchi Gerolamo, Randhawa Premjit S, Andrews Peter J
Department of ENT, Royal National ENT & Eastman Dental Hospitals, London, UK.
Ear Institute, University College London (UCL), London, UK.
SAGE Open Med. 2020 Jul 1;8:2050312120936731. doi: 10.1177/2050312120936731. eCollection 2020.
The ear, nose and throat region has been reported to be one of the commonest sites involved in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis diseases and often precedes the diagnosis of ANCA-associated vasculitis by many months. Although treatment for ANCA-associated vasculitis primarily requires systemic immunosuppressive therapy, there are specific indications for sinonasal surgery during the course of the disease process. The three major roles for surgery in sinonasal vasculitis are to aid diagnosis through biopsy, enable symptom relief and nasal reconstructive surgery consideration when in remission.
The aim of this systematic review is to provide an overview of the surgical procedures which can be performed in patients with ANCA-associated vasculitis presenting with sinonasal involvement.
A systematic literature search was performed for scientific articles on MEDLINE (PubMed Advanced MEDLINE Search) and EMBASE. The search included all articles up to April 2020.
Surgical intervention during the active phase of ANCA-associated vasculitis disease can improve the patient's symptoms and enable histological diagnosis. The surgical decision to manage the nose requires a multidisciplinary approach involving the vasculitis specialist and the ear, nose and throat surgeon. Nasal reconstruction can be performed to restore form and function but only when the disease is in remission so as to maximise success and minimise complications.
据报道，耳、鼻、喉区域是抗中性粒细胞胞浆抗体（ANCA）相关血管炎疾病最常累及的部位之一，且常在ANCA相关血管炎诊断前数月出现。虽然ANCA相关血管炎的治疗主要需要全身免疫抑制治疗，但在疾病过程中鼻窦手术有特定指征。鼻窦血管炎手术的三个主要作用是通过活检辅助诊断、缓解症状以及在病情缓解时考虑鼻重建手术。
本系统评价的目的是概述可在出现鼻窦受累的ANCA相关血管炎患者中进行的手术操作。
在MEDLINE（PubMed高级MEDLINE搜索）和EMBASE上对科学文章进行系统文献检索。检索包括截至2020年4月的所有文章。
在ANCA相关血管炎疾病的活动期进行手术干预可改善患者症状并实现组织学诊断。处理鼻部的手术决策需要血管炎专科医生和耳鼻喉科医生参与的多学科方法。鼻重建可在疾病缓解时进行，以恢复形态和功能，从而最大限度地提高成功率并减少并发症。
