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翼管神经切断术治疗慢性鼻-鼻窦炎伴鼻息肉及变应性鼻炎的临床疗效

Clinical Efficacy of Single Vidian Neurectomy in Chronic Rhinosinusitis with Nasal Polyps and Allergic Rhinitis.

作者信息

Zhuo Hedi, Wang Yanjie, Qi Xueping, Xue Jinmei, An Yunfang, Zhao Changqing

机构信息

Department of Otolaryngology-Head & Neck Surgery, Shanxi Medical University Second Affiliated Hospital, Taiyuan, China.

出版信息

J Coll Physicians Surg Pak. 2022 May;32(5):618-622. doi: 10.29271/jcpsp.2022.05.618.

Abstract

OBJECTIVE

To investigate the clinical efficacy of single Vidian neurectomy (sVN) in the treatment of chronic rhinosinusitis with nasal polyps and allergic rhinitis (CRSwNP &AR).

STUDY DESIGN

Descriptive study.   Place and Duration of Study: Otolaryngology-Head &Neck Surgery, Shanxi Medical University Second Affiliated Hospital, Taiyuan, China, February 2016 to February 2019.

METHODOLOGY

Patients meeting the diagnostic criteria for AR and CRSwNP confirmed after assessment by an ENT physician; moderately severe and persistent AR, aged ≥18 years to ≤70 years; and testing positive for sIgE and were regularly treated with medications for three months or more before surgery with unsatisfactory symptom control. Exclusion criteria were patients with acute exacerbations of sinusitis or fungal sinusitis combined with nasal polyps, intolerant to aspirin, acute infection or sinus tumours; contraindications to general anaesthetic surgery or oral corticosteroids; and those who have received allergen immunotherapy, corticosteroids and antihistamines within one year. The relevant epidemiological data were collected, including IgE level, VAS, RQLQ, and the Lund-Kennedy scores, to assess patients' clinical symptoms and quality of life before and after surgery.

RESULTS

Fifty-five patients were followed up for two years after surgery, and statistical analysis was performed using SPSS version 25.0. It was found that VAS scores, RQLQ scores, and Lund-Kennedy scores of the patients who underwent sVN were significantly lower at six months (all p <0.01), one year (all p <0.01, and two years all p <0.01) after surgery compared with those before surgery.

CONCLUSION

sVN has better efficacy in patients with CRSwNP&AR, has the potential to reduce its recurrence rate, and seems to be a safe and effective treatment.

KEY WORDS

Chronic rhinosinusitis with nasal polyps, Allergic rhinitis, Eosinophilic chronic rhinosinusitis with nasal polyps, Single Vidian neurectomy, Clinical efficacy.

摘要

目的

探讨单翼管神经切断术(sVN)治疗慢性鼻-鼻窦炎伴鼻息肉及变应性鼻炎(CRSwNP&AR)的临床疗效。

研究设计

描述性研究。研究地点和时间:中国山西省太原市山西医科大学第二附属医院耳鼻咽喉头颈外科,2016年2月至2019年2月。

方法

经耳鼻喉科医生评估确诊符合AR和CRSwNP诊断标准的患者;中重度持续性AR,年龄≥18岁至≤70岁;sIgE检测呈阳性,且术前规律用药3个月以上但症状控制不佳。排除标准为鼻窦炎急性加重或合并鼻息肉的真菌性鼻窦炎患者、阿司匹林不耐受者、急性感染者或鼻窦肿瘤患者;全身麻醉手术或口服糖皮质激素的禁忌证患者;以及1年内接受过变应原免疫治疗、糖皮质激素和抗组胺药治疗的患者。收集相关流行病学数据,包括IgE水平、视觉模拟评分(VAS)、鼻炎生活质量问卷(RQLQ)和Lund-Kennedy评分,以评估患者手术前后的临床症状和生活质量。

结果

55例患者术后随访2年,采用SPSS 25.0版进行统计分析。结果发现,接受sVN手术的患者术后6个月(所有p<0.01)、1年(所有p<0.01)和2年(所有p<0.01)时的VAS评分、RQLQ评分和Lund-Kennedy评分均显著低于术前。

结论

sVN对CRSwNP&AR患者疗效较好,有降低其复发率的潜力,似乎是一种安全有效的治疗方法。

关键词

慢性鼻-鼻窦炎伴鼻息肉;变应性鼻炎;嗜酸性粒细胞性慢性鼻-鼻窦炎伴鼻息肉;单翼管神经切断术;临床疗效

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