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慢性鼻-鼻窦炎伴鼻息肉患者内镜鼻窦手术后的长期鼻腔-鼻窦结局的系统评价:呼吁使用统一和标准化的标准和术语。

Systematic Review of Long Term Sinonasal Outcomes in CRSwNP after Endoscopic Sinus Surgery: A call for Unified and Standardized Criteria and Terms.

机构信息

Rhinology and Skull Base Unit, Department of Oto rhinolaryngology, Hospital Clinic Barcelona, Barcelona, Spain.

Universitat de Barcelona, Barcelona, Spain.

出版信息

Curr Allergy Asthma Rep. 2024 Aug;24(8):443-456. doi: 10.1007/s11882-024-01154-w. Epub 2024 Jun 24.

Abstract

PURPOSE OF REVIEW

To present current evidence in long-term (> 5 years) results after endoscopic sinus surgery (ESS) focusing on Patients Reported Outcome Measures (PROMs) and other sinonasal outcomes while assessing the role of ESS in the treatment of CRSwNP, and identifying outcomes which affect the results of ESS and defining recommendations for future studies.

RECENT FINDINGS

Long-term results of ESS in CRSwNP can be branched in PROMs and other objective measurements. Despite the heterogeneity of reported outcomes make it difficult to perform comparisons and meta-analysis, ESS improves PROMs, including symptoms, QOL and olfaction. Objectives outcomes such as NPS, LMS, type of surgery, or recurrence and revision surgery don't have a clear role in long-term results. Clustering patients suggest asthma, N-ERD, allergy, eosinophil count and IL-5 could have a role in predicting recurrence and severe disease. Long-term studies of CRSwNP treated with ESS are scarce. There is a significant need to standardize the report of results. The use of tools as SNOT-22, NPS, validated smell tests, defined criteria for disease recurrence and control and ESS extension in a unified systematic way could allow better comparisons between treatments in the new era of biologics.

摘要

目的

介绍内镜鼻窦手术(ESS)后长期(>5 年)结果的最新证据,重点关注患者报告的结果测量指标(PROMs)和其他鼻-鼻窦结果,同时评估 ESS 在慢性鼻窦炎伴鼻息肉(CRSwNP)治疗中的作用,并确定影响 ESS 结果的因素,并为未来的研究提出建议。

最近的发现

CRSwNP 患者 ESS 的长期结果可分为 PROMs 和其他客观测量指标。尽管报告的结果存在异质性,使得进行比较和荟萃分析变得困难,但 ESS 可改善 PROMs,包括症状、生活质量和嗅觉。客观结果,如 NPS、LMS、手术类型、复发和再次手术,在长期结果中没有明确的作用。聚类患者表明,哮喘、非变应性鼻炎伴鼻后滴注(N-ERD)、过敏、嗜酸性粒细胞计数和 IL-5 可能与复发和严重疾病有关。ESS 治疗 CRSwNP 的长期研究很少。因此,非常有必要规范结果的报告。以统一的系统使用 SNOT-22、NPS、经过验证的嗅觉测试、疾病复发和控制的定义标准以及 ESS 扩展等工具,可以在生物制剂的新时代更好地比较不同治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0c7/11297087/3808e11ce003/11882_2024_1154_Fig1_HTML.jpg

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