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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.

DOI:10.1002/oto2.23
PMID:36998566
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10046702/
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
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb58/10046702/3eab2d640029/OTO2-7-e23-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb58/10046702/3eab2d640029/OTO2-7-e23-g001.jpg

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本文引用的文献

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A review of frontal sinus balloon dilation.额窦球囊扩张术综述。
Int Forum Allergy Rhinol. 2022 Oct;12(10):1310-1312. doi: 10.1002/alr.22991. Epub 2022 Mar 16.
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Current indications for balloon sinuplasty.球囊鼻窦成形术的当前适应症。
Curr Opin Otolaryngol Head Neck Surg. 2019 Feb;27(1):7-13. doi: 10.1097/MOO.0000000000000506.
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Visualized ethmoid roof cerebrospinal fluid leak during frontal balloon sinuplasty.额窦球囊鼻窦成形术中可视化的筛窦顶脑脊液漏
Ear Nose Throat J. 2018 Aug;97(8):E34-E38. doi: 10.1177/014556131809700807.
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Outcomes and Complications of Balloon and Conventional Functional Endoscopic Sinus Surgery.球囊与传统功能性鼻内镜鼻窦手术的疗效与并发症
Am J Rhinol Allergy. 2018 Sep;32(5):388-396. doi: 10.1177/1945892418782248. Epub 2018 Jun 27.
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Use of balloon catheter dilation vs. traditional endoscopic sinus surgery in management of light and severe chronic rhinosinusitis of the frontal sinus: a multicenter prospective randomized study.球囊导管扩张术与传统内镜鼻窦手术治疗轻、重度额窦慢性鼻-鼻窦炎的多中心前瞻性随机研究。
Eur Rev Med Pharmacol Sci. 2018 Jan;22(2):285-293. doi: 10.26355/eurrev_201801_14170.
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Clinical Consensus Statement: Balloon Dilation of the Sinuses.临床共识声明:鼻窦球囊扩张术。
Otolaryngol Head Neck Surg. 2018 Feb;158(2):203-214. doi: 10.1177/0194599817750086.
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A six-month analysis of frontal sinus drainage pathway in patients with frontal sinusitis after balloon sinuplasty.球囊鼻窦成形术后额窦炎患者额窦引流途径的六个月分析
Acta Otolaryngol. 2017 Sep;137(9):968-974. doi: 10.1080/00016489.2017.1300941. Epub 2017 Mar 16.
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Efficacy of balloon sinuplasty in treatment of frontal rhinosinusitis: a prospective study in sixty patients.
Clin Otolaryngol. 2017 Aug;42(4):908-911. doi: 10.1111/coa.12814. Epub 2017 Jan 9.
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Balloon Catheter Dilation of the Frontal Sinus Ostium.额窦开口的球囊导管扩张术
Otolaryngol Clin North Am. 2016 Aug;49(4):965-74. doi: 10.1016/j.otc.2016.03.020.
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Preventing and Managing Complications in Frontal Sinus Surgery.额窦手术中并发症的预防与管理
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