Verma Payal, Rawat Digvijay Singh, Aseri Yogesh, Verma Praveen Chandra, Singh B K
Department of ENT, JLN Medical College and Hospitals, Ajmer, Rajasthan 305001 India.
Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):792-799. doi: 10.1007/s12070-020-01847-4. Epub 2020 Apr 7.
Chronic rhinosinusitis (CRS) significantly affect the quality of life (QoL) of patients. The study was conducted in CRS patients who were treated with functional endoscopic sinus surgery (FESS) after failure of medical treatment to analyze clinical outcome using prospectively collected data through a symptom-based rhinosinusitis outcome measure, the Sino-nasal Outcome Test-22 (SNOT-22). The aim of the study was to evaluate and compare the QoL in patients of chronic rhinosinusitis pre-operative and after FESS by SNOT-22. The prospective study was conducted on 40 patients of chronic rhinosinusitis with or without nasal polyposis. Demographic, clinical, diagnostic nasal endoscopy and radiological findings were recorded. Visual analogue scoring and SNOT-22 questionnaire scoring were done preoperatively and at 3rd and 6th months post-operatively. These scores were compared and a value of < 0.01 was considered statistical significant. Nasal obstruction (80%) was the most commonly reported disabling condition followed by rhinorrhea (75%), facial pain-pressure (72.5%), headache and sneezing. The mean preoperative nasal endoscopy score was 8.08 ± 3.65. The mean preoperative Lund Mackay CT scan score was 11.725 ± 3.64. The mean preoperative SNOT-22 score was 46.25 ± 20.44. After FESS, nasal discharge was improved in 86% patients. Average VAS scores showed significant postoperative improvement at 6 months (< 0.01). The mean postoperative diagnostic nasal endoscopy score improved to 2.80 ± 1.64 at 6 months (< 0.01). The mean postoperative SNOT-22 scores decreased at postoperative follow up visits at 3 and 6 months to 14.58 ± 4.90 at 3 months and 22.38 ±7.93 at 6 months (< 0.01). CRS patient refractory to medical treatment showed statistical significant improvement after FESS. The SNOT-22 scoring was easy to use scoring used for QoL assessment showed significant improvement after FESS.
慢性鼻-鼻窦炎（CRS）显著影响患者的生活质量（QoL）。本研究针对药物治疗失败后接受功能性鼻内镜鼻窦手术（FESS）的CRS患者开展，通过基于症状的鼻-鼻窦炎结局测量工具——鼻窦结局测试-22（SNOT-22），利用前瞻性收集的数据来分析临床结局。本研究的目的是通过SNOT-22评估和比较慢性鼻-鼻窦炎患者术前及FESS术后的生活质量。对40例有或无鼻息肉的慢性鼻-鼻窦炎患者进行了前瞻性研究。记录了人口统计学、临床、诊断性鼻内镜检查和影像学检查结果。术前以及术后第3个月和第6个月进行视觉模拟评分和SNOT-22问卷调查评分。对这些评分进行比较，P值<0.01被认为具有统计学意义。鼻阻塞（80%）是最常报告的致残状况，其次是鼻漏（75%）、面部疼痛-压痛（72.5%）、头痛和打喷嚏。术前鼻内镜检查平均评分为8.08±3.65。术前Lund Mackay CT扫描平均评分为11.725±3.64。术前SNOT-22平均评分为46.25±20.44。FESS术后，86%的患者鼻分泌物得到改善。平均视觉模拟评分显示术后6个月有显著改善（P<0.01）。术后6个月诊断性鼻内镜检查平均评分改善至2.80±1.64（P<0.01）。术后3个月和6个月随访时，术后SNOT-22平均评分下降，3个月时为14.58±4.90，6个月时为22.38±7.93（P<0.01）。药物治疗无效的CRS患者在FESS术后显示出统计学上的显著改善。SNOT-22评分易于使用，用于生活质量评估，FESS术后显示出显著改善。
