{"title":"变应性鼻炎的手术方法:系统评价方案。","authors":"Soumya Soumya, Gideon Adegboyega, Hassan Elhassan","doi":"10.29337/ijsp.160","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Exposure to inhaled allergens in patients with allergic rhinitis results in IgE mediated hypersensitivity of nasal mucosa. The mainstay of management is allergen identification and avoidance, pharmacotherapy with antihistamines, corticosteroids and nasal douching and immunotherapy. Patients refractory to medical management can be offered surgical interventions aimed at providing symptom relief. The objective of this review is to evaluate the effectiveness of surgical intervention on functional and symptomatic outcomes in patients with allergic rhinitis that have failed medical management.</p><p><strong>Methods: </strong>Prospective and retrospective studies that assess the effectiveness of intranasal surgery to include inferior turbinate surgery, posterior nerve resection, vidian neurectomy, septoplasty and endoscopic sinus surgery (ESS) in patients that have failed medical treatment for proven allergic rhinitis. Medline, Web of Science and Embase will be searched for studies published in English from 1990. Two authors will independently screen the search results and assess the full text of potentially relevant studies. 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引用次数: 4
摘要
背景:变应性鼻炎患者吸入过敏原可导致IgE介导的鼻黏膜超敏反应。管理的主要是过敏原识别和避免，药物治疗与抗组胺药，皮质类固醇和鼻冲洗和免疫治疗。难治性的患者可以通过外科手术来缓解症状。本综述的目的是评估手术干预对医疗管理失败的变应性鼻炎患者功能和症状结局的有效性。方法:前瞻性和回顾性研究，评估鼻内手术的有效性，包括下鼻甲手术、后神经切除术、vidian神经切除术、鼻中隔成形术和内窥镜鼻窦手术(ESS)对治疗失败的变应性鼻炎患者。Medline、Web of Science和Embase将检索1990年以来用英文发表的研究。两位作者将独立筛选搜索结果并评估潜在相关研究的全文。符合纳入标准的研究将被严格评估，数据将由两位作者提取和综合。伦理和传播:本研究不需要伦理批准，因为将收集次要数据。研究结果将通过同行评议的医学杂志发布。系统评价注册:本方案已在国际前瞻性系统评价注册(PROSPERO;注册号:CRD42020223773)。过敏性鼻炎(AR)是一种慢性免疫介导的炎症性鼻炎，其典型症状是打喷嚏、鼻塞、粘液排出和不良病例嗅觉丧失。为了缓解AR的症状，耳鼻喉科医生采取了大量的干预措施，然而，文献尚未确定哪种方法对患者的预后和生活质量最好。本研究的主要目的是对所有用于AR治疗的手术干预进行系统的定性分析。
Surgical Approaches for Allergic Rhinitis: A Systematic Review Protocol.
Background: Exposure to inhaled allergens in patients with allergic rhinitis results in IgE mediated hypersensitivity of nasal mucosa. The mainstay of management is allergen identification and avoidance, pharmacotherapy with antihistamines, corticosteroids and nasal douching and immunotherapy. Patients refractory to medical management can be offered surgical interventions aimed at providing symptom relief. The objective of this review is to evaluate the effectiveness of surgical intervention on functional and symptomatic outcomes in patients with allergic rhinitis that have failed medical management.
Methods: Prospective and retrospective studies that assess the effectiveness of intranasal surgery to include inferior turbinate surgery, posterior nerve resection, vidian neurectomy, septoplasty and endoscopic sinus surgery (ESS) in patients that have failed medical treatment for proven allergic rhinitis. Medline, Web of Science and Embase will be searched for studies published in English from 1990. Two authors will independently screen the search results and assess the full text of potentially relevant studies. Studies that meet the inclusion criteria will be critically appraised and the data will be extracted and synthesised by two authors.
Ethics and dissemination: Ethical approval was not required for this study as secondary data will be collected. The results will be disseminated through peer-reviewed medical journal.
Systematic review registration: This protocol has been registered on the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD42020223773).
Highlights: Allergic rhinitis (AR) is a chronic immune-mediated inflammatory nasal condition with hallmark symptoms of sneezing, nasal obstruction, mucus discharge and anosmia in adverse cases.A plethora of interventions are at the hands of otolaryngologists in order to relieve symptoms of AR, however literature is yet to determine which method is best for patient outcome and quality of life.The primary objective of this study is to convey a systematic qualitative analysis of all the surgical interventions used in AR management.
期刊介绍：
Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance.
Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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