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变应性慢性鼻-鼻窦炎患者内镜鼻窦手术后鼻息肉复发的危险因素

Risk Factors for Recurrence of Nasal Polyps after Endoscopic Sinus Surgery in Patients with Allergic Chronic Rhino Sinusitis.

作者信息

Mohamed Wael Shehata, El Ghonemy Mohamed Talaat, Saber Shaimaa Fathy, Azooz Khaled Omar

机构信息

Otorhinolaryngology Department, Faculty of Medicine, October 6th University, Cairo, Egypt.

Otorhinolaryngology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

出版信息

Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):3379-3385. doi: 10.1007/s12070-023-03988-8. Epub 2023 Jun 23.

Abstract

Rhino sinusitis, is a common inflammatory disease that affects the nasal cavity and paranasal sinuses in millions of individuals. Chronic sinusitis patients complain of a combination of nasal obstruction, rhinorrhea, post nasal drip and facial pain. To identify the risk factors of the recurrence of nasal polyps in chronic rhino sinusitis patients after endoscopic sinus surgery. After a review of 60 patients with chronic rhino sinusitis with failed medical treatment requiring FESS presenting in Kasr Alainy Hospital in Cairo University and October 6 University Hospital from May 2022 to March 2023. All patients were subjected to history taking, clinical examination including endoscopy, subjective evaluation of symptoms and CT-scan. Of our patients, six patients (15%) were diagnosed with recurrence of nasal polyps with chronic rhino sinusitis and needed revision surgery. There are multiple risk factors related to the recurrence of nasal polyps including smoking followed by having a history of an asthma, the presence of an allergy, septal deviation, prior sinus surgery, and turbinate hypertrophy. Other factors, as proper medical treatment such as topical steroids and treatment of allergy had a significant role in decreasing the recurrence rate. Risk factors related to the recurrence of nasal polyps should be avoided before surgery. The avoidance of risk factors protects the patients from the recurrence of nasal polyps, the hazards of anaesthesia on surgical treatment, and the financial cost of surgery. Follow up is important in the prevention of recurrence of nasal polyps and improves the symptoms.

摘要

鼻-鼻窦炎是一种常见的炎症性疾病,影响着数百万人的鼻腔和鼻窦。慢性鼻窦炎患者会出现鼻塞、流涕、鼻后滴漏和面部疼痛等多种症状。目的是确定慢性鼻-鼻窦炎患者在内镜鼻窦手术后鼻息肉复发的危险因素。回顾了2022年5月至2023年3月在开罗大学的卡斯尔·阿莱尼医院和十月六日大学医院就诊的60例药物治疗无效、需要进行功能性内镜鼻窦手术(FESS)的慢性鼻-鼻窦炎患者。所有患者均接受了病史采集、包括内镜检查在内的临床检查、症状的主观评估以及CT扫描。在我们的患者中,有6例(15%)被诊断为慢性鼻-鼻窦炎鼻息肉复发,需要进行翻修手术。与鼻息肉复发相关的危险因素有多个,包括吸烟,其次是有哮喘病史、存在过敏、鼻中隔偏曲、既往鼻窦手术史以及鼻甲肥大。其他因素,如适当的药物治疗,如局部使用类固醇和治疗过敏,在降低复发率方面具有重要作用。手术前应避免与鼻息肉复发相关的危险因素。避免危险因素可使患者免受鼻息肉复发、麻醉对手术治疗的危害以及手术的经济成本。随访对于预防鼻息肉复发和改善症状很重要。

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Prognostic factors for polyp recurrence in chronic rhinosinusitis with nasal polyps.慢性鼻-鼻窦炎伴鼻息肉中息肉复发的预测因素。
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Differentially expressed Secretoglobin 1C1 gene in nasal polyposis.鼻息肉中差异表达的分泌球蛋白1C1基因。
Cell Mol Biol (Noisy-le-grand). 2018 Jan 31;64(1):97-102. doi: 10.14715/cmb/2018.64.1.17.

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