中央区特应性疾病及其手术效果:嗅觉变化和技术说明。

0 OTORHINOLARYNGOLOGY
Therapeutic advances in allergy and rhinology Pub Date : 2023-12-03 eCollection Date: 2023-01-01 DOI:10.1177/27534030231217423
Sheng-Kai Huang, Ching-Hung Hsieh, Ming-Chian Weng, Jen-Tsung Lai, Ping-Hung Shen
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引用次数: 0

摘要

背景:中央隔室特应性疾病(CCAD)是慢性鼻炎的一种最新表型。只有少数研究对 CCAD 患者的嗅觉功能进行了评估:我们旨在研究 CCAD 患者在功能性内窥镜鼻窦手术(FESS)后嗅觉功能的变化,并提出一些手术技巧来提高此类患者的术后嗅觉效果:设计:一项回顾性队列研究:我们收集了 2018 年 6 月至 2021 年 12 月期间由台湾外科医生实施 FESS 的 23 名 CCAD 患者(8 男 15 女)的数据。分析了纳入患者的人口统计学数据、嗅觉功能以及血清和组织中嗜酸性粒细胞的百分比。采用顶级国际生技嗅觉识别测试(TIBSIT;顶级国际生技,台湾台北)评估嗅觉功能:结果:在 23 名患者中,大多数(95%)对空气过敏原呈阳性反应,2 名患者(8.7%)患有哮喘。10名患者(43.5%)患有外周嗜酸性粒细胞增多症,9名患者(39%)患有嗜酸性粒细胞鼻息肉。此外,患者还伴有不同程度的嗅觉功能障碍;术前 TIBSIT(pr-TIBSIT)平均得分为 12.8 ± 2.3(范围:0-43),而术后 TIBSIT(po-TIBSIT)平均得分为 29.2 ± 1.9(范围:16-44)。术后 TIBSIT 评分明显优于术前 TIBSIT 评分(配对 t 检验,P 结论:术后 TIBSIT 评分明显优于术前 TIBSIT 评分:我们的研究结果表明,CCAD 与嗅觉功能障碍密切相关,而 FESS 可有效改善嗅觉功能。为优化术后嗅觉效果,建议在不损伤神经上皮的情况下精确切除嗅裂中的息肉。我们的研究为接受 FESS 手术的 CCAD 患者的管理提供了有价值的见解,并可指导手术决策,以达到最佳的嗅觉功能效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Central Compartment Atopic Disease and Its Surgical Outcomes: Olfactory Changes and Technical Notes.

Background: Central compartment atopic disease (CCAD) is a recent, novel phenotype of chronic rhinosinusitis. Only a few studies have assessed olfactory function in patients with CCAD.

Objectives: We aimed to investigate olfactory function changes after functional endoscopic sinus surgery (FESS) in patients with CCAD and proposed some surgical techniques to enhance the postoperative olfactory outcomes in such patients.

Design: A retrospective cohort study.

Methods: We collected data from 23 patients (8 men and 15 women) with CCAD who underwent FESS performed by a surgeon in Taiwan, between June 2018 and December 2021. The demographic data, olfactory function, and serum and tissue eosinophil percentages of the included patients were analyzed. The Top International Biotech Smell Identification Test (TIBSIT; Top International Biotech, Taipei, Taiwan) was used to assess olfactory function.

Results: Of the 23 patients, most (95%) showed a positive reaction to aeroallergens, and 2 patients (8.7%) had asthma. Ten patients (43.5%) had peripheral eosinophilia, and 9 (39%) had eosinophilic nasal polyps. Moreover, the patients presented with variable olfactory dysfunction; the mean preoperative TIBSIT (pr-TIBSIT) score was 12.8 ± 2.3 (range: 0-43), whereas the mean postoperative TIBSIT (po-TIBSIT) score was 29.2 ± 1.9 (range: 16-44). The po-TIBSIT score was significantly better than the pre-TIBSIT score (paired t test, P < .0001). The improvement in olfactory function was not significantly correlated with the patients' age, serum eosinophil percentages, and nasal polyp eosinophil counts.

Conclusion: Our findings indicate that CCAD is significantly associated with olfactory dysfunction and that FESS can effectively improve olfactory function. To optimize postoperative olfactory outcomes, precise removal of polyps from the olfactory cleft without damaging the neuroepithelium is recommended. Our study provides valuable insights into the management of CCAD patients undergoing FESS and can guide surgical decision-making to achieve optimal olfactory function outcomes.

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