Ziegler Andrea, Patadia Monica, Patel Chirag
Department of Otolaryngology Loyola University Medical Center Maywood Illinois USA.
World J Otorhinolaryngol Head Neck Surg. 2022 Nov 23;9(2):183-188. doi: 10.1002/wjo2.84. eCollection 2023 Jun.
Resection of the middle turbinate (MT) during endoscopic sinus surgery (ESS) has been a controversial topic among otolaryngologists for many years. Some studies advocate resection and have shown improved outcomes postoperatively, while studies favoring preservation show a decreased incidence of postoperative complications. The current practice pattern regarding this subject is unknown. The goal of this study was to learn the current practice of MT resection during ESS among otolaryngologists.
We performed an electronic anonymous survey of practicing otolaryngologists.
We found that the majority of the 252 responders stated that they will perform an MT resection in certain clinical situations, while there is a small subset that advocates never resecting the MT for inflammatory sinus disease ( = 6, 2.4%). Participants were significantly more likely to perform MT resection in patients undergoing revision compared to primary ESS for all conditions included. The complication of greatest concern among participants was iatrogenic frontal sinus obstruction, while empty nose was of the least concern. The majority of participants responded that MT resection was of extreme or moderate benefit for improved visualization and drug delivery postoperatively. When compared to general otolaryngologists, fellowship-trained rhinologists were less concerned about potential complications following MT resection and were more likely to perceive an extreme or moderate benefit from turbinate resection postoperatively.
There remains debate over MT resection among otolaryngologists, but the results of this study show that the majority of participating otolaryngologists will perform a resection in certain clinical situations.
多年来,在内镜鼻窦手术(ESS)中切除中鼻甲(MT)一直是耳鼻喉科医生之间存在争议的话题。一些研究主张切除,并显示术后效果有所改善,而支持保留的研究则显示术后并发症的发生率降低。目前关于这个问题的实践模式尚不清楚。本研究的目的是了解耳鼻喉科医生在ESS中进行MT切除的当前做法。
我们对执业耳鼻喉科医生进行了一项电子匿名调查。
我们发现,252名受访者中的大多数表示,他们会在某些临床情况下进行MT切除,而有一小部分人主张从不因炎性鼻窦疾病而切除MT(n = 6,2.4%)。在所有纳入的情况下,与初次ESS相比,参与者在接受翻修手术的患者中进行MT切除的可能性显著更高。参与者最担心的并发症是医源性额窦阻塞,而空鼻症最不值得担心。大多数参与者回答说,MT切除对术后改善可视化和药物输送有极大或中等程度的益处。与普通耳鼻喉科医生相比,接受过专科培训的鼻科医生不太担心MT切除后的潜在并发症,并且更有可能认为鼻甲切除术后有极大或中等程度的益处。
耳鼻喉科医生对MT切除仍存在争议,但本研究结果表明,大多数参与研究的耳鼻喉科医生会在某些临床情况下进行切除。