Extent of Endoscopic Sinus Surgery in Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis.

IF 5.4 2区医学 Q1 ALLERGY

Current Allergy and Asthma Reports Pub Date : 2024-11-01 Epub Date: 2024-09-09 DOI:10.1007/s11882-024-01175-5

Thinh Tran, Phillip Staibano, Kornkiat Snidvongs, Thomas B V Nguyen, Doron D Sommer

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Abstract

Purpose of review: There is an incomplete understanding regarding the extent of endoscopic sinus surgery (ESS) in managing chronic rhinosinusitis (CRS) and its effect on outcomes. This study aimed to assess and compare limited sinus surgery, full-house, extended and radical ESS for optimizing CRS outcomes.

Recent findings: An online search in adherence with PRISMA guidelines was performed. Data were pooled for meta-analysis. Forty-six articles met inclusion criteria. Full-house ESS yielded greater improvements in SNOT-22 and endoscopy scores over limited ESS. Radical ESS improved nasal symptoms and reduced disease recurrence more than full house ESS, while extended ESS decreased revision ESS rates when compared to full-house ESS. Total ethmoidectomy reduced SNOT-22 scores more than limited ethmoidectomy. There was no difference in perioperative complications for all extents of ESS. When compared to limited ESS, full-house ESS yielded better patient symptom outcomes. Radical ESS demonstrated even greater reductions in nasal symptoms, while extended ESS additionally decreased revision surgery rates. Thus, in general, greater extent of ESS leads to better outcomes, while all extents of ESS are relatively safe.

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内窥镜鼻窦手术在慢性鼻窦炎中的应用范围：系统回顾与元分析》。

综述目的：关于内窥镜鼻窦手术（ESS）治疗慢性鼻窦炎（CRS）的范围及其对疗效的影响，目前尚无完整的认识。本研究旨在评估和比较有限鼻窦手术、全鼻窦手术、扩大鼻窦手术和根治性鼻窦手术，以优化 CRS 的治疗效果：根据PRISMA指南进行了在线搜索。数据汇总后进行了荟萃分析。46篇文章符合纳入标准。与局限性ESS相比，全室ESS在SNOT-22和内窥镜检查评分方面有更大的改善。根治性ESS比全套ESS更能改善鼻部症状和减少疾病复发，而与全套ESS相比，扩展性ESS降低了ESS的复发率。全乙状结肠切除术比局限性乙状结肠切除术更能降低 SNOT-22 评分。所有范围的ESS在围手术期并发症方面均无差异。与局限性ESS相比，全切ESS能更好地改善患者症状。根治性ESS对鼻部症状的缓解作用更大，而扩展性ESS则额外降低了翻修手术率。因此，总的来说，更大程度的ESS会带来更好的疗效，而所有程度的ESS都相对安全。

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

Current Allergy and Asthma Reports 医学-过敏

CiteScore

11.20

自引率

1.80%

发文量

审稿时长

6-12 weeks

期刊介绍： The aim of Current Allergy and Asthma Reports is to systematically provide the views of highly selected experts on current advances in the fields of allergy and asthma and highlight the most important papers recently published. All reviews are intended to facilitate the understanding of new advances in science for better diagnosis, treatment, and prevention of allergy and asthma. We accomplish this aim by appointing international experts in major subject areas across the discipline to review select topics emphasizing recent developments and highlighting important new papers and emerging concepts. We also provide commentaries from well-known figures in the field, and an Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research. Over a one- to two-year period, readers are updated on all the major advances in allergy and asthma.