Hentati Firas, Kim Jaehee, Hoying David, D'Anza Brian, Rodriguez Kenneth
Case Western Reserve University School of Medicine, Cleveland, Ohio, U.S.A.
University Hospitals Cleveland Medical Center, Cleveland, Ohio, U.S.A.
Laryngoscope. 2023 Nov;133(11):2878-2884. doi: 10.1002/lary.30647. Epub 2023 Mar 27.
The purpose of this study is to determine the impact of demographics and sinonasal comorbidities on the revision rate of functional endoscopic sinus surgery (FESS) for chronic rhinosinusitis (CRS).
Although endoscopic sinus surgery (ESS) is often successful in providing long-term relief for patients suffering from CRS, revision surgery can occur. There is conflicting literature on the impact of race on FESS outcomes.
A single-center retrospective cohort study of patients that underwent FESS for CRS between January 1, 2015 and June 1, 2021 at a single tertiary care academic center.
A total of 682 patients between the ages of 18 and 89 underwent primary ESS between January 1, 2015 and June 1, 2021 and were included in this study. Of these patients, 388 (56.9%) were female, with an average age of 48.6 ± 16.7. Thirty-eight patients (5.6%) underwent revision sinus surgery during the study period. Patients that identified as White had significantly lower rates of revision sinus surgery (4.1%) than non-White patients (10.7%), including those identifying as Asian, Black, multiracial, or other. On multivariate analysis, non-White race (OR 4.933), polyposis (3.175), and high preoperative SNOT-22 scores (OR 1.029) were independently associated with revision sinus surgery. The mean preoperative SNOT-22 for all participants was 39.1 ± 22.0, whereas the mean postoperative SNOT-22 was 20.6 ± 17.5 (p < 0.001).
Race plays an important role in outcomes following revision sinus surgery that is independent of location and insurance status. More studies are required to assess the reason race plays an important role in outcomes following revision sinus surgery.
Level 3 Laryngoscope, 133:2878-2884, 2023.
本研究旨在确定人口统计学因素和鼻窦合并症对慢性鼻窦炎（CRS）功能性鼻内镜鼻窦手术（FESS）翻修率的影响。
尽管鼻内镜鼻窦手术（ESS）通常能成功为CRS患者提供长期缓解，但仍可能需要进行翻修手术。关于种族对FESS结果的影响，文献报道存在矛盾。
对2015年1月1日至2021年6月1日期间在一家三级医疗学术中心因CRS接受FESS的患者进行单中心回顾性队列研究。
2015年1月1日至2021年6月1日期间，共有682例年龄在18至89岁之间的患者接受了初次ESS，并纳入本研究。其中，388例（56.9%）为女性，平均年龄为48.6±16.7岁。在研究期间，38例（5.6%）患者接受了鼻窦翻修手术。认定为白人的患者鼻窦翻修手术率（4.1%）显著低于非白人患者（10.7%），非白人患者包括亚洲人、黑人、多种族或其他种族。多因素分析显示，非白人种族（比值比4.933）、息肉病（3.175）和术前高SNOT-22评分（比值比1.029）与鼻窦翻修手术独立相关。所有参与者术前SNOT-22的平均值为39.1±22.0，而术后SNOT-22的平均值为20.6±17.5（p<0.001）。
种族在鼻窦翻修手术后的结果中起着重要作用，且独立于地理位置和保险状况。需要更多研究来评估种族在鼻窦翻修手术后结果中起重要作用的原因。
3级 喉镜，133:2878 - 2884，2023年
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