Article record

恰当范围的内镜鼻窦手术为慢性鼻窦炎患者带来良好的治疗结局。

Appropriate extent of endoscopic sinus surgery brings favorable therapeutic outcomes to chronic rhinosinusitis patients.

临床研究鼻科IF 2.3Q1

文献信息

PMID	42867643
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Thinh Tran 查看其他 15 位作者 Jompol Samuthpongtorn；Kachorn Seresirikachorn；Wirach Chitsuthipakorn；Minh P Hoang；Luan V Tran；Minh T Q Le；Deasi Anggraini；Retno S Wardani；Sakinah Mohamad；Baharudin Abdullah；Terese Low；Soma Subramaniam；Prem Wungcharoen；Supinda Chusakul；Kornkiat Snidvongs
作者单位	Department of Otolaryngology, Faculty of Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh city, Vietnam. 查看其他 12 条单位信息 Graduate Program in Clinical Sciences, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.；Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 Road, Pathumwan, Bangkok, 10330, Thailand.；Department of Otolaryngology, Rajavithi Hospital, Bangkok, Thailand.；College of Medicine, Rangsit University, Bangkok, Thailand.；Department of Otolaryngology, University of Medicine and Pharmacy, Hue University, Hue, Vietnam.；Ear Nose and Throat hospital Ho Chi Minh city, Ho Chi Minh city, Vietnam.；Rhinology division, Department of Otolaryngology, Persahabatan Hospital, Academic Health system University of Indonesia, Jakarta, Indonesia.；Rhinology division, ENT Department, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo National Hospital Jakarta, Jakarta, Indonesia.；Department of Otorhinolaryngology - Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kota Bharu, Kelantan, Malaysia.；Department of Otolaryngology, Ng Teng Fong General Hospital, Jurong East, Singapore.；Endoscopic Nasal and Sinus Excellent Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.；Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 Road, Pathumwan, Bangkok, 10330, Thailand. drkornkiat@yahoo.com.
期刊	European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
SCI 分区	Q1
IF	2.3
研究类型	临床研究 · 临床
所属专科	鼻科

中文摘要

目的： 慢性鼻窦炎（CRS）患者内镜鼻窦手术（ESS）的最佳范围仍未确定。本研究旨在评估当ESS范围与 underlying 病理生理一致时的术后结局。
方法： 本研究纳入116例计划接受三类ESS的CRS患者：局限ESS、全组ESS和扩大ESS。一致性ESS定义为：（1）对需要通气和引流的患者实施局限ESS；（2）对需要局部治疗入路的患者实施全组ESS或扩大ESS。术后结局包括症状视觉模拟量表（VAS）、鼻-鼻窦结局测试（SNOT-22）和内镜评分。
结果： 一年时，接受一致性ESS的患者在症状VAS（平均差[MD] 1.38；95% CI 0.62-2.15；P < 0.01）、SNOT-22（MD 22.73；95% CI 15.46-30.00；P < 0.01）和内镜评分（MD 6.48；95% CI 1.96-11.00；P < 0.01）方面取得了更优的结局。当ESS用于改善通气和引流时，局限ESS和全组ESS带来了相当的结局。在SNOT-22方面，局限ESS比扩大ESS取得了更好的结局（MD -21.05；95% CI -38.72至-3.37；P = 0.02）。当ESS旨在为局部治疗提供入路时，与局限ESS相比，全组ESS（MD 21.32；95% CI 10.01-32.62；P < 0.01）和扩大ESS（MD 26.16；95% CI 14.85-37.46；P < 0.01）对SNOT-22的改善更大。
结论： ESS的范围应根据 underlying 病理生理进行个体化调整。局限ESS和全组ESS适合改善通气。当需要局部治疗入路时，全组ESS和扩大ESS提供更好的结局。

英文摘要

PURPOSE: The optimal extent of endoscopic sinus surgery (ESS) for patients with chronic rhinosinusitis (CRS) remains undetermined. This study aimed to evaluate postoperative outcomes when the extent of ESS is concordant with the underlying pathophysiology.
METHODS: This study enrolled 116 patients with CRS scheduled for three categories of ESS: limited ESS, full-house ESS, and extended ESS. Concordant ESS was defined as (1) limited ESS performed for patients requiring ventilation and drainage and (2) either full-house ESS or extended ESS performed for patients requiring access for topical therapies. Postoperative outcomes included symptom visual analogue scale (VAS), the Sino-Nasal Outcome Test (SNOT-22), and endoscopic scores.
RESULTS: At one year, patients receiving concordant ESS achieved superior outcomes in symptom VAS (mean difference [MD] 1.38; 95% CI 0.62-2.15; P < 0.01), SNOT-22 (MD 22.73; 95% CI 15.46-30.00; P < 0.01), and endoscopic scores (MD 6.48; 95% CI 1.96-11.00; P < 0.01). When ESS was performed to improve ventilation and drainage, limited ESS and full-house ESS brought comparable outcomes. Limited ESS achieved better outcomes than extended ESS in SNOT-22 (MD - 21.05; 95% CI - 38.72 to - 3.37; P = 0.02). When ESS aimed to provide access for topical therapies, SNOT-22 was greater improved by full-house (MD 21.32; 95% CI 10.01-32.62; P < 0.01) and extended ESS (MD 26.16; 95% CI 14.85-37.46; P < 0.01) compared to limited ESS.
CONCLUSIONS: The extent of ESS should be tailored to the underlying pathophysiology. Limited and full-house ESS are appropriate to improve ventilation. Full-house and extended ESS provide better outcomes when access for topical therapies is required.