慢性鼻-鼻窦炎伴鼻息肉患者内镜鼻窦手术翻修的临床和影像学危险因素的多变量分析：表型可以预测复发吗？
Multivariate analysis of clinical and radiological risk factors for revision endoscopic sinus surgery in patients with chronic rhinosinusitis with nasal polyps: can phenotype predict recurrence?
机构信息
Department of Otolaryngology - Head and Neck Surgery, İzmir Atatürk Research and Education Hospital, İzmir, Turkey and Izmir University of Economics, Faculty of Medicine, Medical Point Hospital, İzmir, Turkey.
Otolaryngology - Head and Neck Surgery Clinic, Acıbadem Eskişehir Hospital, Eskişehir, Turkey.
出版信息
J Laryngol Otol. 2024 May;138(5):527-534. doi: 10.1017/S0022215123001962. Epub 2023 Nov 24.
OBJECTIVE
This study aimed to analyse clinical and radiological features (phenotypes) to predict revision risk after functional endoscopic sinus surgery in patients with chronic rhinosinusitis with nasal polyps.
METHOD
Phenotype characteristics of the patients with chronic rhinosinusitis with nasal polyps who underwent functional endoscopic sinus surgery were analysed retrospectively.
RESULTS
The rates of asthma, aspirin sensitivity, smoking and a positive prick test result were significantly higher in revision functional endoscopic sinus surgery cases ( < 0.001, 0.001, < 0.001 and < 0.001, respectively). Multivariate analysis demonstrated that only gender, pre-operative nasal steroid use, pre-operative systemic steroid use, intra-operative systemic steroid use and smoking were significant risk factors for revision functional endoscopic sinus surgery ( = 0.034, 0.001, 0.010, 0.007 and 0.001, respectively). In addition, only eosinophilia and aspirin sensitivity were significant risk factors for multiple revision functional endoscopic sinus surgery procedures ( = 0.043 and 0.005, odds ratio = 2.4 and 5.2).
CONCLUSION
Beyond the endotype of chronic rhinosinusitis with nasal polyps, defining clinical and radiological factors enables a valid prediction of patients at high risk of revision functional endoscopic sinus surgery.
目的
本研究旨在分析慢性鼻-鼻窦炎伴鼻息肉患者功能性内镜鼻窦手术后的临床和影像学特征（表型），以预测其翻修风险。
方法
回顾性分析行功能性内镜鼻窦手术的慢性鼻-鼻窦炎伴鼻息肉患者的表型特征。
结果
翻修功能性内镜鼻窦手术组中哮喘、阿司匹林过敏、吸烟和皮试阳性率显著更高（<0.001、0.001、<0.001 和<0.001）。多因素分析显示，仅性别、术前鼻用皮质类固醇、术前全身皮质类固醇、术中全身皮质类固醇和吸烟是翻修功能性内镜鼻窦手术的显著危险因素（=0.034、0.001、0.010、0.007 和 0.001）。此外，只有嗜酸性粒细胞增多和阿司匹林过敏是多次翻修功能性内镜鼻窦手术的显著危险因素（=0.043 和 0.005，优势比=2.4 和 5.2）。
结论
除了慢性鼻-鼻窦炎伴鼻息肉的内型外，明确临床和影像学因素可有效预测翻修功能性内镜鼻窦手术风险较高的患者。
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