Tayside Rhinology Mega-Clinic and Scottish Centre for Respiratory Research, Ninewells Hospital and Medical School, University of Dundee, Scotland, UK.
Department of Doctoral Studies, Riga Stradins University, Riga, Latvia.
J Laryngol Otol. 2023 Nov;137(11):1277-1284. doi: 10.1017/S0022215123000853. Epub 2023 May 22.
Some chronic rhinosinusitis with nasal polyps patients undergo revision surgery at some point following initial functional endoscopic sinus surgery. This review aimed to identify the predictive factors for recurrence of nasal polyps requiring oral corticosteroids or revision surgery in chronic rhinosinusitis with nasal polyps following functional endoscopic sinus surgery.
A retrospective analysis of 221 patients who underwent functional endoscopic sinus surgery for chronic rhinosinusitis with nasal polyps in a tertiary rhinology centre, between January 2015 and December 2018, was undertaken.
Forty-four (21.6 per cent) patients underwent medical polypectomy, 19 (9 per cent) underwent revision surgery and 51 (24.3 per cent) underwent combined polypectomy during the mean follow-up time of 5.3 years. Patients aged less than 55 years of age, with a history of previous functional endoscopic sinus surgery, peripheral blood eosinophil counts of 300 cells/μl or higher, a Lund-Mackay score of more than 17 and concomitant aspirin-exacerbated respiratory disease had significantly increased odds for medical polypectomy, revision surgery and combined polypectomy.
Knowing these predictive factors, clinicians can better identify patients with an increased likelihood of severe polyp recurrence and therefore arrange closer follow-up to optimise therapy.
一些慢性鼻-鼻窦炎伴鼻息肉患者在初次功能性内镜鼻窦手术后的某个时间点需要进行翻修手术。本研究旨在确定功能性内镜鼻窦手术后慢性鼻-鼻窦炎伴鼻息肉患者需要口服皮质类固醇或翻修手术的鼻息肉复发的预测因素。
回顾性分析了 2015 年 1 月至 2018 年 12 月在一家三级鼻科中心接受功能性内镜鼻窦手术治疗的 221 例慢性鼻-鼻窦炎伴鼻息肉患者。
在平均 5.3 年的随访期间，44 例（21.6%）患者接受了药物息肉切除术，19 例（9%）患者接受了翻修手术，51 例（24.3%）患者接受了联合息肉切除术。年龄<55 岁、有既往功能性内镜鼻窦手术史、外周血嗜酸性粒细胞计数>300 个/μl、Lund-Mackay 评分>17 分和伴有阿司匹林加重的呼吸道疾病的患者，行药物息肉切除术、翻修手术和联合息肉切除术的可能性显著增加。
了解这些预测因素，临床医生可以更好地识别出鼻息肉严重复发可能性增加的患者，从而安排更密切的随访以优化治疗。
