Alfattani Naif, Alqurashi Abdulmohsen S, Kabli Abdulrahman F, Haji Aseel, Alharthi Bassam T, Mandili Ammar K
Otolaryngology-Head and Neck Surgery, Al-Noor Specialist Hospital, Makkah, SAU.
Medicine and Surgery, Umm Al-Qura University, Makkah, SAU.
Cureus. 2023 Aug 13;15(8):e43398. doi: 10.7759/cureus.43398. eCollection 2023 Aug.
Objectives Chronic rhinosinusitis (CRS) is the persistent inflammation of the mucosal lining of the paranasal sinuses (PNS). By definition, the inflammatory process persists beyond 12 weeks. One of its subtypes is allergic fungal rhinosinusitis (AFRS), which has a high risk of recurrence, leading to revision surgery. This study aimed to establish the predictive factors for the recurrence of AFRS in post-sinus surgery patients. Methods This single-center retrospective study was conducted in Al-Noor Specialist Hospital, Makkah, Saudi Arabia. The charts of patients with AFRS who underwent surgery in our rhinology clinic between 2000 and 2020 were reviewed. Results Among the 116 patients included in this study, approximately half (53%) were female, with a median age of 24.5 years. Thirty-nine (33.6%) patients had recurrence post-sinus surgery, with 33.3% occurring within six months of follow-up. The results showed that patients with coexisting bronchial asthma were three times more likely to experience recurrence (adjusted odds ratio {AOR}, 3.43; confidence interval {CI}, 1.35-8.71), patients with uncorrected deviated nasal septum (DNS) were three times more likely to experience symptoms again following surgery (AOR, 3.70; CI, 1.14-12.02), and patients who presented with concomitant sinus headaches are 66% less likely to experience recurrence (AOR, 0.34; CI, 0.13-0.86). Conclusion The results showed that 33.62% of patients experienced recurrence following surgery. Bronchial asthma and DNS were strongly associated with recurrence; however, their presence does not always imply the need for additional surgery.
目的 慢性鼻-鼻窦炎（CRS）是鼻窦（PNS）黏膜内衬的持续性炎症。根据定义，炎症过程持续超过12周。其亚型之一是变应性真菌性鼻-鼻窦炎（AFRS），具有较高的复发风险，常需再次手术。本研究旨在确定鼻窦手术后AFRS复发的预测因素。方法 本单中心回顾性研究在沙特阿拉伯麦加的努尔专科医院进行。回顾了2000年至2020年间在我院鼻科门诊接受手术的AFRS患者的病历。结果 本研究纳入的116例患者中，约一半（53%）为女性，中位年龄为24.5岁。39例（33.6%）患者鼻窦手术后复发，33.3%在随访6个月内复发。结果显示，合并支气管哮喘的患者复发可能性高3倍（调整优势比{AOR}，3.43；置信区间{CI}，1.35 - 8.71），鼻中隔偏曲（DNS）未矫正的患者术后再次出现症状的可能性高3倍（AOR，3.70；CI，1.14 - 12.02），伴有鼻窦头痛的患者复发可能性降低66%（AOR，0.34；CI，0.13 - 0.86）。结论 结果显示，33.62%的患者术后复发。支气管哮喘和DNS与复发密切相关；然而，它们的存在并不总是意味着需要再次手术。
