Impact of Allergy on the Prognosis of Functional Endoscopic Sinus Surgery

過敏對功能性鼻竇內視鏡手術預後的影響

梁凱莉(Kai-Li Liang) ； 蘇茂昌(Mao-Chang Su) ； 江榮山(Rong-San Jiang)

《Mid-Taiwan Journal of Medicine》 10卷2期 (2005/06) Pp. 78-83

https://doi.org/10.6558/MTJM.2005.10(2).4

摘要

目的　功能性鼻竇內視鏡手術是目前慢性鼻炎鼻竇炎手術的首選。許多文獻報告功能性鼻竇內視鏡手術有很優秀長短期的追蹤結果。但相關於過敏對功能性鼻竇內視鏡手術的影響之研究並不多。本研究之目的為瞭解過敏對功能性鼻竇內視鏡手術短期預後的影響。
方法　於2000年1月至2003年2月間收集因藥物治療無效接受功能性鼻竇內視鏡手術的患者。所有患者在術前均接受皮膚試驗、鼻竇電腦斷層及問卷訪視。問卷內容包含10項常見之鼻炎鼻竇炎症狀，其中五項屬過敏相關症狀（鼻塞、流鼻涕、打噴涕、鼻癢、與喘鳴），五項屬非過敏相關症狀（鼻涕倒流、嗅覺改變、臉痛或頭痛、耳塞與咳嗽）。所有患者均於術後接受類似藥物。患者於術後6個月再接受問卷訪視以評估主觀預後。將過敏與非過敏患者之問卷分數作一比較。
結果　共116名患者進入本研究。過敏與非過敏患者在術前的問卷分數無有意義的差別。術後兩組之鼻炎鼻竇炎問卷總分及非過敏相關症狀分數無統計上差異，但過敏相關症狀呈有意義的差別。
結論　接受功能性鼻竇內視鏡手術的過敏患者若有適當的術後控制過敏，與非過敏者短期預後相當。

關鍵字

過敏 ； 漫性鼻炎鼻竇炎 ； 功能性鼻竇內視鏡手術

並列摘要

Purpose Functional endoscopic sinus surgery (FESS) is currently the standard surgical treatment for chronic rhinosinusitis (CRS) refractory to medical therapy. Many studies have reported that patients treated with FESS had excellent objective and subjective outcomes. However, only a few reports have discussed the influence of allergy on the outcome of FESS. The purpose of this study was to understand the impact of allergy on the short-term outcome of FESS.
Methods A total of 116 patients with CRS who underwent FESS from June 2000 to February 2003 were enrolled in this study. Patients underwent an intradermal skin test, coronal sinus computed tomography (CT) scan and a questionnaire assessment before FESS was performed. The questionnaire was a 10-item scale developed by the authors to assess rhinosinusitis symptoms. Five items were allergy-related (nasal obstruction, rhinorrhea, sneezing, nasal itching and wheezing) and the remaining five were nonallergy-related (post nasal drip, olfactory disorder, headache or facial pain, ear blockage and cough). All patients in this study received similar medication after operation. Rhinosinusitis symptoms were reevaluated by questionnaires 6 months postoperatively. The questionnaire scores before and after FESS were compared between allergic and non-allergic patients and analyzed by the Mann-Whitney Utest.
Results. There were no significant differences in preoperative rhinosinusitis scores between allergic and non-allergic patients. There were no significant differences in the total and nonallergy-related rhinosinusitis scores between the two groups postoperatively. However, the postoperative allergy-related rhinosinusitis scores were significantly higher in allergic patients. conclusions. The short-term outcome of FESS was similar in allergic and non-allergic CRS patients when allergic patients received adequate pharmacotherapy to control allergy symptoms.

並列關鍵字

allergy ； chronic rhinosinusitis ； functional endoscopic sinus surgery