Department of Otorhinolaryngology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Department of Otorhinolaryngology, Faculty of medicine, Kafrelsheikh University, Kafrelsheikh, Egypt.
Clin Otolaryngol. 2021 Jul;46(4):834-840. doi: 10.1111/coa.13750. Epub 2021 Mar 10.
The study aimed to assess the association between the preoperative CT findings and the patency outcome of the frontal sinus after endoscopic frontal sinusotomy in the early follow-up period.
A prospective cohort study.
Tertiary hospital centre.
The study measures the association between the frontal sinusotomy outcome and the standard preoperative radiological scores, including Harvard, Kennedy and Lund-Mackay. It also measures the impact of the degree of sinus mucosal thickness on the outcome. Furthermore, it measures the effect of the anteroposterior lengths of both the frontal sinus ostium and the frontal recess on postoperative frontal sinus patency.
Harvard, Kennedy and modified Lund-Mackay scores showed no evidence of association with the frontal sinusotomy patency outcome (P-values .397, .487 and .501), respectively. Still, the Lund-Mackay score showed a negative correlation with symptom improvement. Sinuses with a high-grade mucosal thickness on CT scan were associated with high failure rates (P-value: .009*). The anteroposterior length of the frontal sinus ostium significantly affects the outcome (P-value: .001*). In contrast, there was no association between the anteroposterior length of the frontal recess and the outcome (P-value: .965).
The Harvard, Kennedy and Lund-Mackay scores could not predict the frontal sinusotomy patency outcome. Failed cases were associated with advanced degrees of mucosal pathology in the preoperative CT scan. Sinuses ostia with anteroposterior diameters less than 5.36 mm showed more susceptibility for sinus restenosis postoperatively. The variability of the anteroposterior length of the frontal recess did not affect the surgical outcome.
本研究旨在评估术前 CT 表现与内镜额窦切开术后早期额窦通畅情况之间的关系。
前瞻性队列研究。
三级医院中心。
研究测量了额窦切开术结果与标准术前放射评分（包括 Harvard、Kennedy 和 Lund-Mackay 评分）之间的相关性，还测量了鼻窦黏膜增厚程度对结果的影响。此外，还测量了额窦口和额隐窝前后长度对术后额窦通畅性的影响。
Harvard、Kennedy 和改良 Lund-Mackay 评分与额窦切开术通畅结果均无明显相关性（P 值分别为.397、.487 和.501）。然而，Lund-Mackay 评分与症状改善呈负相关。CT 扫描显示鼻窦黏膜增厚程度较高的鼻窦与较高的失败率相关（P 值：.009*）。额窦口前后径显著影响手术结果（P 值：.001*）。相比之下，额隐窝前后径与结果无明显相关性（P 值：.965）。
Harvard、Kennedy 和 Lund-Mackay 评分不能预测额窦切开术的通畅结果。失败病例与术前 CT 扫描中黏膜病变程度较高有关。前后径小于 5.36 mm 的窦口更容易发生术后窦口再狭窄。额隐窝前后径的变化不影响手术结果。
