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吸烟与非吸烟人群鼻-鼻中隔手术的结局。

Nasoseptal Surgery Outcomes in Smokers and Nonsmokers.

机构信息

Otolaryngology-Head and Neck Surgery, Madigan Army Medical Center, Tacoma, Washington, USA.

Otolaryngology-Head and Neck Surgery, Tripler Army Medical Center, Honolulu, Hawaii, USA.

出版信息

Facial Plast Surg Aesthet Med. 2021 Jul-Aug;23(4):283-288. doi: 10.1089/fpsam.2020.0349. Epub 2020 Aug 26.

Abstract

Many surgeons refuse to perform elective nasal surgery in active smokers, but little literature exists that addresses the risks of doing so; we sought to quantify the differences in outcomes after nasal surgery among smokers, previous smokers, and nonsmokers by measuring complication rates, revision rates, and improvement in Nasal Obstruction Symptom Evaluation (NOSE) scores. We performed a single institution retrospective review of patients undergoing nasoseptal surgery. Specifically, we noted demographic characteristics, smoking status, surgery type, and pre- and postoperative NOSE scores. We compared NOSE scores, complication rates, and revision rates among current smokers, previous smokers, and never smokers. Five hundred thirty patients were included for complication and revision rate analysis; there was no difference in complication or revision rates among patients of different smoking categories. Two hundred ninety-one patients completed pre- and postoperative NOSE scores. Scores for all surgeries and in all smoking categories improved postoperatively ( < 0.001). There was a difference in NOSE score change among surgical groups, with rhinoplasty resulting in the greatest improvement ( = 0.044). There was no difference in NOSE score improvement across smoking categories. Active smokers benefit from surgical intervention and can expect a similar improvement in nasal breathing to their nonsmoking counterparts if they meet indications for and undergo nasal surgery.

摘要

许多外科医生拒绝为活跃吸烟者进行择期鼻部手术,但很少有文献探讨这样做的风险;我们通过测量并发症发生率、修正率和鼻阻塞症状评估(NOSE)评分的改善程度,来量化吸烟、曾经吸烟和不吸烟患者接受鼻部手术后结果的差异。我们对接受鼻中隔鼻成形术的患者进行了单机构回顾性研究。具体来说,我们记录了人口统计学特征、吸烟状况、手术类型以及术前和术后的 NOSE 评分。我们比较了当前吸烟者、曾经吸烟者和不吸烟者的 NOSE 评分、并发症发生率和修正率。共有 530 例患者进行了并发症和修正率分析;不同吸烟类别的患者在并发症或修正率方面没有差异。291 例患者完成了术前和术后的 NOSE 评分。所有手术和所有吸烟类别的评分在术后均有改善( < 0.001)。不同手术组的 NOSE 评分变化存在差异,鼻整形术的改善最大( = 0.044)。吸烟类别对 NOSE 评分改善没有影响。活跃吸烟者可以从手术干预中受益,如果符合适应证并接受鼻部手术,他们可以期待与不吸烟患者相似的改善。

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