Schaitkin B, May M, Shapiro A, Fucci M, Mester S J
Sinus Surgery Center, Shadyside Hospital, Pittsburgh, PA.
Laryngoscope. 1993 Oct;103(10):1117-20. doi: 10.1288/00005537-199310000-00007.
Endoscopic sinus surgery has been reported to be successful, but lack of a standardized classification system hampers comparison of results between studies, and long-term results of surgery have not been reported in a series of consecutive patients. The results of our first 100 endoscopic sinus surgery procedures, reported previously after an average 9-month follow-up, were reviewed with the application of a new classification scheme and in light of a longer (4-year) follow-up. Surgery was successful in all patients whose sinus symptoms resulted from anatomical variations or suppurative infection, but failed in some patients with hyperplastic disease or polyps. In addition, the presence of reactive airway disease or the acetylsalicylic acid (ASA) triad was a bad prognostic sign. The overall success of the procedure in relieving sinus symptoms decreased from 98% at early follow-up to 91% at 4-year follow-up. Sixty-six percent were successful after one procedure and 25% required more than one procedure to achieve success. The decline in success since our first report in 1990 was mostly attributable to late failure in patients with recurrent symptomatic polyposis. Because symptoms may not recur in these patients for up to 3 years, long-term results of surgery for this disorder are necessary. Symptoms of recurrent polyposis can be controlled medically or by revision surgery.
据报道，内镜鼻窦手术是成功的，但缺乏标准化的分类系统阻碍了不同研究结果之间的比较，并且尚未有一系列连续患者的手术长期结果报告。我们应用一种新的分类方案，并结合更长时间（4年）的随访，对之前报道的前100例内镜鼻窦手术的结果进行了回顾，此前的报告是在平均9个月的随访后得出的。对于所有鼻窦症状由解剖变异或化脓性感染引起的患者，手术均成功，但对于一些增生性疾病或息肉患者，手术失败。此外，存在反应性气道疾病或阿司匹林三联征是不良预后标志。该手术缓解鼻窦症状的总体成功率从早期随访时的98%降至4年随访时的91%。66%的患者一次手术后成功，25%的患者需要不止一次手术才能成功。自1990年我们首次报告以来成功率的下降主要归因于复发性症状性息肉患者的晚期失败。由于这些患者的症状可能长达3年都不复发，因此有必要了解该疾病手术的长期结果。复发性息肉的症状可以通过药物治疗或翻修手术来控制。
