Alba Rubra Polyclinic, Zagreb, Croatia.
School of Medicine, University of Zagreb, Zagreb, Croatia.
Acta Clin Croat. 2022 Aug;61(2):342-348. doi: 10.20471/acc.2022.61.02.21.
This study analyzed the characteristics of chronic rhinosinusitis patients with and without nasal polyps failing conservative treatment and undergoing functional endoscopic sinus surgery as part of their treatment for chronic inflammatory sinonasal disease. The aim of this retrospective single-institution cohort study conducted at a university hospital tertiary referral center was to evaluate the characteristics of patients with both disease phenotypes in whom conservative treatment was unsuccessful. Patients who were surgically treated with functional endoscopic sinus surgery performed by two rhinology surgeons during a one-year period (2016) were enrolled in the study. Patient data collection included demographics, risk factor exposure, diagnosis, and type of endoscopic surgical procedure performed. In total, 185 patients were included in the study. Patients with malignant disease and those with incomplete data were excluded from the study. In the group of patients with nasal polyps, mean age, male gender, presence of allergy (34.9%), asthma (21.4%), aspirin sensitivity (6.3%), cystic fibrosis (1.6%), and previous nasal surgery rates (36.5%) were significantly higher as compared with the group of patients with chronic rhinosinusitis without nasal polyps. Septal deviation was more prevalent in the chronic rhinosinusitis group (55%) as compared to the group with nasal polyps (25%). The ethmoid (17%) and maxillary sinus (13%) were most frequently involved, but most of the patients who needed surgery had involvement of multiple or all sinuses (40%). The reasons for conservative treatment failure in chronic rhinosinusitis are multifactorial, but identifying the most prevalent characteristics in patients treated surgically may be helpful in identifying patients who would benefit most from surgery.
本研究分析了慢性鼻-鼻窦炎伴或不伴鼻息肉患者的特征，这些患者在保守治疗失败后接受了功能性内镜鼻窦手术作为其慢性炎症性鼻-鼻窦疾病治疗的一部分。这项回顾性单中心队列研究在一家大学医院三级转诊中心进行，旨在评估对保守治疗无效的两种疾病表型患者的特征。在一年（2016 年）期间，由两位鼻科医生进行功能性内镜鼻窦手术治疗的患者被纳入研究。患者数据收集包括人口统计学、危险因素暴露、诊断和进行的内镜手术类型。共有 185 名患者纳入研究。患有恶性疾病和资料不完整的患者被排除在研究之外。在鼻息肉患者组中，平均年龄、男性、过敏（34.9%）、哮喘（21.4%）、阿司匹林敏感性（6.3%）、囊性纤维化（1.6%）和既往鼻手术率（36.5%）显著高于无鼻息肉的慢性鼻-鼻窦炎患者组。鼻中隔偏曲在慢性鼻-鼻窦炎组（55%）更为常见，而在鼻息肉组（25%）中则更为常见。筛窦（17%）和上颌窦（13%）最常受累，但大多数需要手术的患者存在多个或所有鼻窦受累（40%）。慢性鼻-鼻窦炎保守治疗失败的原因是多因素的，但确定接受手术治疗患者的最常见特征可能有助于确定最受益于手术的患者。
