Senior B A, Kennedy D W, Tanabodee J, Kroger H, Hassab M, Lanza D
Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Medical Center, Philadelphia, USA.
Laryngoscope. 1998 Feb;108(2):151-7. doi: 10.1097/00005537-199802000-00001.
Although much has been reported on the short-term outcomes of functional endoscopic sinus surgery (FESS), little has been reported with regard to its long-term impact on chronic sinusitis. The senior author (D.W.K.) previously reported detailed subjective and endoscopic follow-up on 120 patients at a mean of 18 months following surgery. This current study represents a long-term follow-up (average, 7.8 years) of 72 patients (60%) from the same cohort. Of patients responding to a question about overall symptoms, 98.4% (n = 66) reported improvement compared with before surgery. There was a trend toward continued subjective improvement in symptom scores with longer follow-up, but the changes did not reach statistical significance. Thirteen patients (18%) required subsequent surgical procedures. Preoperative stage, prior surgery, and other factors that might affect outcome were evaluated. The study demonstrates that excellent subjective results following FESS can be maintained in the long term with appropriate postoperative management. The study also validates the concept that patients in whom the cavity can be normalized following surgery are unlikely to require further surgery.
尽管关于功能性鼻内镜鼻窦手术(FESS)的短期疗效已有大量报道,但关于其对慢性鼻窦炎的长期影响报道较少。资深作者(D.W.K.)此前报告了120例患者术后平均18个月的详细主观及内镜随访情况。本研究是对同一队列中72例患者(60%)的长期随访(平均7.8年)。在回答关于总体症状问题的患者中,98.4%(n = 66)报告与术前相比症状有所改善。随着随访时间延长,症状评分有持续主观改善的趋势,但变化未达到统计学意义。13例患者(18%)需要后续手术治疗。对术前分期、既往手术及其他可能影响预后的因素进行了评估。该研究表明,通过适当的术后管理,FESS术后长期可保持优异的主观效果。该研究还证实了术后术腔能够恢复正常的患者不太可能需要进一步手术这一概念。