Hur Kevin, Gao Jaynelle, Adili Amila, Tam Benjamin, Herrera Kevin, Rice Dale, Wrobel Bozena, Wu Shinyi
Caruso Department of Otolaryngology-Head & Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, U.S.A.
Department of Population and Public Health Sciences, Keck School of Medicine, Southern California Clinical and Translational Science Institute (SC-CTSI), University of Southern California, Los Angeles, California, U.S.A.
Laryngoscope. 2025 Jun;135(6):1920-1927. doi: 10.1002/lary.31982. Epub 2025 Jan 2.
There has been limited research on the influence of race and ethnicity on treatment decision-making for chronic rhinosinusitis (CRS). This prospective study aims to investigate potential factors linked to treatment modality choice among patients with medically refractory CRS, distinguishing between Chinese American and non-Chinese American patients.
CRS patients with persistent symptoms despite prior medical treatment were prospectively enrolled. These patients chose either to continue medical treatment or to undergo endoscopic sinus surgery (ESS) to alleviate CRS symptoms. Demographic and clinical characteristics were compared using bivariate analysis. The association between ethnicity and treatment modality choice was assessed using multivariable logistic regression.
Among the 134 patients (29.1% Chinese Americans) included, 79 patients (59.0%) elected to undergo ESS. No significant differences in demographics, nasal polyp status, comorbidities, Sinonasal Outcome Test (SNOT-22), Lund-Mackay, or modified Lund-Kennedy scores were found between the treatment groups. After adjusting for age, income, and SNOT-22 score, non-Chinese American patients were more inclined to select ESS (OR = 7.92; 95% CI: 2.95-21.28; p < 0.001) as opposed to Chinese American patients. Chinese American patients who underwent ESS had a clinically significant improvement in SNOT-22 scores at 1 month (-11.29 points) and 3 months (-16.29 points) postoperatively.
Chinese American patients with refractory CRS are less likely to opt for ESS compared to non-Chinese American patients. Surgical treatment is effective in improving quality of life, as measured by the SNOT-22, among Chinese American CRS patients. Further investigations are warranted to identify factors contributing to surgical hesitancy.
3 Laryngoscope, 135:1920-1927, 2025.
关于种族和民族对慢性鼻-鼻窦炎（CRS）治疗决策的影响，相关研究有限。本前瞻性研究旨在调查难治性CRS患者中与治疗方式选择相关的潜在因素，区分华裔美国患者和非华裔美国患者。
前瞻性纳入尽管先前接受过药物治疗但仍有持续症状的CRS患者。这些患者选择继续药物治疗或接受鼻内镜鼻窦手术（ESS）以缓解CRS症状。使用双变量分析比较人口统计学和临床特征。使用多变量逻辑回归评估种族与治疗方式选择之间的关联。
在纳入的134例患者（29.1%为华裔美国人）中，79例患者（59.0%）选择接受ESS。治疗组之间在人口统计学、鼻息肉状态、合并症、鼻鼻窦结局测试（SNOT-22）、Lund-Mackay或改良Lund-Kennedy评分方面未发现显著差异。在调整年龄、收入和SNOT-22评分后，非华裔美国患者比华裔美国患者更倾向于选择ESS（OR = 7.92；95% CI：2.95 - 21.28；p < 0.001）。接受ESS的华裔美国患者在术后1个月（-11.29分）和3个月（-16.29分）时SNOT-22评分有临床显著改善。
与非华裔美国患者相比，难治性CRS的华裔美国患者选择ESS的可能性较小。手术治疗对于改善华裔美国CRS患者的生活质量有效，生活质量通过SNOT-22来衡量。有必要进一步调查导致手术犹豫的因素。
3《喉镜》，135:1920 - 1927，2025年。
