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额窦球囊鼻窦成形术——患者满意度及再次手术的预测因素

Frontal Sinus Balloon Sinuplasty-Patient Satisfaction and Factors Predicting Reoperation.

作者信息

Sainio Sara, Blomgren Karin, Koskinen Anni, Lundberg Marie

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery Helsinki University Hospital and University of Helsinki Helsinki Finland.

HUS Joint Resources Helsinki University Hospital and University of Helsinki Helsinki Finland.

出版信息

OTO Open. 2023 Mar 22;7(1):e23. doi: 10.1002/oto2.23. eCollection 2023 Jan-Mar.

Abstract

OBJECTIVE

To explore predictive factors of postoperative outcome of frontal sinus balloon dilation.

STUDY DESIGN

Retrospective questionnaire study.

SETTING

Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Finland.

METHODS

We reviewed electronic records of all patients who underwent frontal sinus balloon dilatation (successful or attempted) in our clinic from 2008 to 2019. We documented patient characteristics, preoperative imaging results, intraoperative factors, possible complications, and reoperations. Those who underwent frontal sinus balloon sinuplasty were sent a questionnaire regarding their current symptoms and long-term satisfaction with surgery.

RESULTS

In total, 258 operations (404 frontal sinuses) were reviewed, with a technical success rate of 93.6% (n = 378). The revision rate was 15.7% (n = 38). Previous sinonasal surgery predicted a higher revision rate ( = .004, odds ratio [OR] = 3.03, 95% confidence interval [CI] 1.40-6.56). Patients with hybrid surgery had significantly fewer reoperations compared to the balloon only group ( = .002, OR = 0.33, 95% CI 0.16-0.67). The response rate of the questionnaire was 64.5% (n = 156), of which 88.5% (n = 138) reported a long-term benefit from the balloon sinuplasty. Patient satisfaction was higher ( = .02, OR = 8.26, 95% CI 1.06-64.24) among patients using nasal corticosteroids.

CONCLUSION

Technical success rate and patient satisfaction after frontal sinus balloon sinuplasty are high. Balloon sinuplasty seems insufficient in reoperations. A hybrid approach appears to result in fewer reoperations than a balloon only approach.

摘要

目的

探讨额窦球囊扩张术后预后的预测因素。

研究设计

回顾性问卷调查研究。

研究地点

芬兰赫尔辛基大学医院及赫尔辛基大学耳鼻咽喉头颈外科。

方法

我们回顾了2008年至2019年在我们诊所接受额窦球囊扩张术(成功或尝试)的所有患者的电子记录。我们记录了患者特征、术前影像学结果、术中因素、可能的并发症及再次手术情况。对接受额窦球囊鼻窦成形术的患者发放了一份关于其当前症状及对手术长期满意度的问卷。

结果

共回顾了258例手术(404个额窦),技术成功率为93.6%(n = 378)。翻修率为15.7%(n = 38)。既往鼻窦手术提示翻修率较高(P = 0.004,比值比[OR] = 3.03,95%置信区间[CI] 1.40 - 6.56)。与单纯球囊组相比,采用联合手术的患者再次手术明显较少(P = 0.002,OR = 0.33,95% CI 0.16 - 0.67)。问卷回复率为64.5%(n = 156),其中88.5%(n = 138)报告球囊鼻窦成形术有长期益处。使用鼻用糖皮质激素的患者满意度更高(P = 0.02,OR = 8.26,95% CI )。

结论

额窦球囊鼻窦成形术的技术成功率和患者满意度较高。球囊鼻窦成形术在再次手术中似乎效果不佳。联合手术方式似乎比单纯球囊手术方式导致的再次手术更少。 (注:原文中最后一个95%CI后面内容缺失)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb58/10046702/3eab2d640029/OTO2-7-e23-g001.jpg

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