Bo Zhang MD , Min Yan MD , Cong Li MD , Jiashu Zhao MD , Yang Liu MD , Xiaomei Yang MD , Xuelan Zeng MD , Zhiying Nie MD , Zhaoyang Ke MD , Wei Zhang MD , Yuanyuan Guo MD , Jianbo Shi MD, PhD , Fenghong Chen MD
{"title":"哮喘严重程度对慢性鼻窦炎合并哮喘患者手术结果的影响。","authors":"Bo Zhang MD , Min Yan MD , Cong Li MD , Jiashu Zhao MD , Yang Liu MD , Xiaomei Yang MD , Xuelan Zeng MD , Zhiying Nie MD , Zhaoyang Ke MD , Wei Zhang MD , Yuanyuan Guo MD , Jianbo Shi MD, PhD , Fenghong Chen MD","doi":"10.1016/j.anai.2024.11.022","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Patients with chronic rhinosinusitis with nasal polyps comorbid with asthma often experience poor outcomes after endoscopic sinus surgery.</div></div><div><h3>Objective</h3><div>To evaluate the impact of asthma severity on the long-term outcomes after surgery in these patients.</div></div><div><h3>Methods</h3><div>A total of 83 patients with chronic rhinosinusitis with nasal polyps comorbid with asthma who underwent endoscopic sinus surgery were prospectively enrolled in this study. Patients were classified into mild, moderate, and severe asthma groups based on their preoperative asthma severity. Clinical symptom scores, nasal endoscopy scores, and asthma control test results were recorded preoperatively and at 1 year and 12 years postoperatively.</div></div><div><h3>Results</h3><div>A total of 71 patients completed the 12-year follow-up. All patients had significant improvement in nasal symptom scores and nasal endoscopy scores. However, 48 of 71 patients (67.6%) experienced nasal polyp recurrence, and 22 of them (31.0%) underwent revision surgery. Patients in the severe asthma group had the highest rate of nasal polyp recurrence (<em>P</em> = .02) and revision surgery (<em>P</em> = .01) and the least improvement in smell disturbance (<em>P</em> = .04) and general symptom (<em>P</em> = .02) compared with the other asthma groups.</div></div><div><h3>Conclusion</h3><div>Preoperative asthma severity significantly influenced the outcome of endoscopic sinus surgery in patients with chronic rhinosinusitis with nasal polyps comorbid with asthma, in whom endoscopic sinus surgery had a long-term beneficial effect.</div></div><div><h3>Trial Registration</h3><div><span><span>https://www.chictr.org.cn/</span><svg><path></path></svg></span>: ChiCTR2100050583.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"134 6","pages":"Pages 676-684.e1"},"PeriodicalIF":4.7000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of asthma severity on surgical outcomes in patients with chronic rhinosinusitis comorbid with asthma\",\"authors\":\"Bo Zhang MD , Min Yan MD , Cong Li MD , Jiashu Zhao MD , Yang Liu MD , Xiaomei Yang MD , Xuelan Zeng MD , Zhiying Nie MD , Zhaoyang Ke MD , Wei Zhang MD , Yuanyuan Guo MD , Jianbo Shi MD, PhD , Fenghong Chen MD\",\"doi\":\"10.1016/j.anai.2024.11.022\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Patients with chronic rhinosinusitis with nasal polyps comorbid with asthma often experience poor outcomes after endoscopic sinus surgery.</div></div><div><h3>Objective</h3><div>To evaluate the impact of asthma severity on the long-term outcomes after surgery in these patients.</div></div><div><h3>Methods</h3><div>A total of 83 patients with chronic rhinosinusitis with nasal polyps comorbid with asthma who underwent endoscopic sinus surgery were prospectively enrolled in this study. Patients were classified into mild, moderate, and severe asthma groups based on their preoperative asthma severity. Clinical symptom scores, nasal endoscopy scores, and asthma control test results were recorded preoperatively and at 1 year and 12 years postoperatively.</div></div><div><h3>Results</h3><div>A total of 71 patients completed the 12-year follow-up. All patients had significant improvement in nasal symptom scores and nasal endoscopy scores. However, 48 of 71 patients (67.6%) experienced nasal polyp recurrence, and 22 of them (31.0%) underwent revision surgery. Patients in the severe asthma group had the highest rate of nasal polyp recurrence (<em>P</em> = .02) and revision surgery (<em>P</em> = .01) and the least improvement in smell disturbance (<em>P</em> = .04) and general symptom (<em>P</em> = .02) compared with the other asthma groups.</div></div><div><h3>Conclusion</h3><div>Preoperative asthma severity significantly influenced the outcome of endoscopic sinus surgery in patients with chronic rhinosinusitis with nasal polyps comorbid with asthma, in whom endoscopic sinus surgery had a long-term beneficial effect.</div></div><div><h3>Trial Registration</h3><div><span><span>https://www.chictr.org.cn/</span><svg><path></path></svg></span>: ChiCTR2100050583.</div></div>\",\"PeriodicalId\":50773,\"journal\":{\"name\":\"Annals of Allergy Asthma & Immunology\",\"volume\":\"134 6\",\"pages\":\"Pages 676-684.e1\"},\"PeriodicalIF\":4.7000,\"publicationDate\":\"2025-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Allergy Asthma & Immunology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1081120624017125\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ALLERGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Allergy Asthma & Immunology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1081120624017125","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ALLERGY","Score":null,"Total":0}
Impact of asthma severity on surgical outcomes in patients with chronic rhinosinusitis comorbid with asthma
Background
Patients with chronic rhinosinusitis with nasal polyps comorbid with asthma often experience poor outcomes after endoscopic sinus surgery.
Objective
To evaluate the impact of asthma severity on the long-term outcomes after surgery in these patients.
Methods
A total of 83 patients with chronic rhinosinusitis with nasal polyps comorbid with asthma who underwent endoscopic sinus surgery were prospectively enrolled in this study. Patients were classified into mild, moderate, and severe asthma groups based on their preoperative asthma severity. Clinical symptom scores, nasal endoscopy scores, and asthma control test results were recorded preoperatively and at 1 year and 12 years postoperatively.
Results
A total of 71 patients completed the 12-year follow-up. All patients had significant improvement in nasal symptom scores and nasal endoscopy scores. However, 48 of 71 patients (67.6%) experienced nasal polyp recurrence, and 22 of them (31.0%) underwent revision surgery. Patients in the severe asthma group had the highest rate of nasal polyp recurrence (P = .02) and revision surgery (P = .01) and the least improvement in smell disturbance (P = .04) and general symptom (P = .02) compared with the other asthma groups.
Conclusion
Preoperative asthma severity significantly influenced the outcome of endoscopic sinus surgery in patients with chronic rhinosinusitis with nasal polyps comorbid with asthma, in whom endoscopic sinus surgery had a long-term beneficial effect.
期刊介绍:
Annals of Allergy, Asthma & Immunology is a scholarly medical journal published monthly by the American College of Allergy, Asthma & Immunology. The purpose of Annals is to serve as an objective evidence-based forum for the allergy/immunology specialist to keep up to date on current clinical science (both research and practice-based) in the fields of allergy, asthma, and immunology. The emphasis of the journal will be to provide clinical and research information that is readily applicable to both the clinician and the researcher. Each issue of the Annals shall also provide opportunities to participate in accredited continuing medical education activities to enhance overall clinical proficiency.