Department of Otolaryngology-Head and Neck Surgery, Mount Sinai School of Medicine, New York, New York, U.S.A.
Laryngoscope. 2021 Oct;131(10):2173-2178. doi: 10.1002/lary.29513. Epub 2021 Mar 22.
OBJECTIVES/HYPOTHESIS: No studies have evaluated the impact of the types of frontal sinus surgery (FSS) on objective olfaction scores. This study evaluated olfactory function and quality of life (QOL) in chronic rhinosinusitis (CRS) patients before and after total ethmoidectomy with frontal sinusotomy (FS).
Prospective cohort study.
A prospective study of adult CRS patients undergoing FSS (Draf 2 or Draf 3 procedures) was conducted at a tertiary care center. Primary outcomes included brief smell identification test (BSIT) and sinonasal outcome test-22 (SNOT-22), which were assessed during preoperative evaluation, 6 to 9 weeks postoperatively, and 12 to 24 weeks postoperatively. Normosmia was defined as BSIT ≥9. Statistical significance was determined using the Wilcoxon signed-rank test with α = .05.
Thirty-eight patients followed up 12 to 24 weeks after FSS. The differences between baseline and long-term outcomes for BSIT (6.11 vs. 8.24, P = .00034) and SNOT-22 (55.49 vs. 24.32, P < .00001) scores were found to be statistically significant. Although both subgroups had clinically significant olfactory improvements, only the Draf 2 cohort experienced a statistically significant improvement in olfaction at long-term follow-up. There was no statistically significant change in data from 6 to 9 weeks to 12 to 24 weeks postoperatively.
Patients undergoing total ethmoidectomy with FS demonstrated statistically significant increases in olfaction and QOL at long-term postoperative follow-up. This study demonstrated that FS does not negatively impact the olfactory improvement seen in sinus surgery. The lack of statistically significant changes in these olfactory metrics from short to long-term follow-up suggests that there is no additional negative effect of FSS in the long term.
3 Laryngoscope, 131:2173-2178, 2021.
目的/假设：目前尚无研究评估不同类型的额窦手术（FSS）对客观嗅觉评分的影响。本研究评估了慢性鼻-鼻窦炎（CRS）患者在接受总筛窦切除术联合额窦切开术（FS）前后的嗅觉功能和生活质量（QOL）。
前瞻性队列研究。
在一家三级医疗中心进行了一项 FSS（Draf 2 或 Draf 3 手术）成年 CRS 患者的前瞻性研究。主要结局包括简短嗅觉识别测试（BSIT）和鼻-鼻窦炎结局测试-22（SNOT-22），在术前评估、术后 6 至 9 周和术后 12 至 24 周进行评估。嗅觉正常定义为 BSIT≥9。使用 Wilcoxon 符号秩检验，α=0.05 确定统计学意义。
38 例患者在 FSS 后 12 至 24 周进行了随访。BSIT（6.11 对 8.24，P=0.00034）和 SNOT-22（55.49 对 24.32，P<0.00001）评分的基线和长期结果之间的差异具有统计学意义。虽然两个亚组的嗅觉均有显著改善，但仅 Draf 2 亚组在长期随访时嗅觉改善具有统计学意义。术后 6 至 9 周至 12 至 24 周的随访中，数据没有统计学意义的变化。
接受 FS 联合总筛窦切除术的患者在长期术后随访中嗅觉和 QOL 均有显著提高。本研究表明，FS 不会对鼻窦手术引起的嗅觉改善产生负面影响。从短期到长期随访，这些嗅觉指标没有统计学意义的变化表明，FSS 不会在长期内产生额外的负面影响。
3 级。喉镜，131：2173-2178，2021。
