Chronic Rhinosinusitis Risk after Maxillectomy with Microvascular Reconstruction.

IF 1.5 4区医学 Q2 OTORHINOLARYNGOLOGY

Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery Pub Date : 2024-07-01 DOI:10.1159/000539604

Michael T Werner, Ryan M Carey, Kush Panara, Jacob Harris, Kendall K Tasche, Robert M Brody, Karthik Rajasekaran, James N Palmer, Nithin D Adappa, Jason G Newman, Rabie M Shanti, Steven B Cannady

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引用次数: 0

Abstract

Introduction: Chronic rhinosinusitis (CRS) can be associated with tumors involving the maxillary sinus, but outcomes after undergoing maxillectomy with free flap reconstruction remain unclear.

Methods: A retrospective analysis of medical records was performed to evaluate evidence of CRS in patients who underwent maxillectomy with free flap reconstruction at a single tertiary care academic institution from 2013 through 2020.

Results: Eighty-four patients were assessed. Nineteen (22.6%) patients were diagnosed with CRS after surgery, 23 (27.4%) patients were treated for sinus symptoms, and 49 (58.3%) had radiographic evidence of sinus inflammation for more than 6 months. Risk factors for requiring sinus treatment included adjuvant or neoadjuvant chemotherapy (p = 0.002) and pre-operative use of sinus medication (p < 0.001). Radiographic evidence of sinusitis 6 months after surgery is also closely associated with sinusitis treatment (p = 0.051).

Conclusions: CRS may be underdiagnosed in patients undergoing maxillectomy with microvascular reconstruction. Further evaluation into patient sinus disease and symptoms following neoplastic surgery may lead to a higher quality of life in some long-term survivors.

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微血管重建上颌骨切除术后的慢性鼻炎风险。

目的慢性鼻窦炎（CRS）可能与累及上颌窦的肿瘤有关，但接受上颌骨切除并游离皮瓣重建术后的效果仍不明确。方法对病历进行回顾性分析，评估 2013 年至 2020 年期间在一家三级医疗学术机构接受上颌骨切除术并行游离皮瓣重建术的患者的 CRS 证据。结果对84名患者进行了评估。19例（22.6%）患者在术后被诊断为CRS，23例（27.4%）患者因鼻窦症状接受了治疗，49例（58.3%）患者的鼻窦炎症影像学证据超过6个月。需要进行鼻窦治疗的风险因素包括辅助化疗或新辅助化疗（p=0.002）和术前使用鼻窦药物（p<0.001）。术后 6 个月鼻窦炎的影像学证据也与鼻窦炎治疗密切相关（p=0.051）。结论在接受上颌骨切除术并进行微血管重建的患者中，CRS 可能被诊断不足。进一步评估肿瘤手术后患者的鼻窦疾病和症状可能会提高一些长期幸存者的生活质量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery 医学-耳鼻喉科学

CiteScore

2.80

自引率

7.70%

发文量

审稿时长

6-12 weeks

期刊介绍： ''ORL'' contains concise, original scientific papers of interest for both clinicians and researchers in oto-rhino-laryngology and head and neck surgery. Contributions drawn from the basic sciences cover new knowledge on the anatomy, pathology, pathophysiology, immunology and tumor biology of head and neck and the auditory and vestibular system, the salivary glands, paranasal sinuses and of the organs of the upper respiratory and digestive tract. The practical value of the journal is accentuated by reports of clinical progress in diagnosis and therapy.