Evaluation of a new and simple classification for endoscopic sinus surgery.
Evaluation of a new and simple classification for endoscopic sinus surgery.
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DOI：
10.2500/ar.2017.8.0208
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发表时间：
2017-10-01
期刊：
影响因子：
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通讯作者：
Nishizaki K
中科院分区：
文献类型：
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作者：
Kanai K;Okano M;Haruna T;Higaki T;Omichi R;Makihara SI;Tsumura M;Kariya S;Hirata Y;Nishizaki K
2013年，日本鼻学会提出了内镜鼻窦手术（ESS）的简单分类。该分类包括五种手术（I型，口鼻道复合体开窗，切除鼻窦并扩大自然口；II型，单窦手术，操纵窦内；III型，多窦手术；IV型，泛窦手术；V型，扩展到窦壁以外的手术）。评估该分类在慢性鼻窦炎（CRS）和鼻副窦囊肿中的临床意义。回顾性验证研究。2012年在冈山大学医院接受ESS治疗的122例患者（195例鼻窦）被纳入研究。分析ESS分型与手术时间、术中出血量、术后嗅觉变化、CT评分、鼻气道阻力等临床病程的关系。共195例ESS手术分为I型（n = 3）、II型（n = 17）、III型（n = 91）、IV型（n = 82）和V型（n = 2）。II型、III型和IV型ESS的主要表型分别为鼻副窦囊肿（68%）、无鼻息肉的CRS（77%）和伴有鼻息肉的CRS(55%)，差异有统计学意义。基于该分级的ESS程度与手术时间、出血量呈正相关。整体而言，术后嗅觉、CT评分、鼻气道阻力均有明显改善。III型和IV型ESS的改善程度相似。这种简单的ESS分类反映了该疾病的围手术期负担。
In 2013, the Japanese Rhinologic Society proposed a simple classification for endoscopic sinus surgery (ESS). This classification consists of five procedures (type I, fenestration of the ostiomeatal complex, with uncinectomy and widening of the natural ostium; type II, single-sinus procedure, with manipulating the inside of the sinus; type III, polysinus procedure; type IV, pansinus procedure; type V, extended procedure beyond the sinus wall). The clinical relevance of this classification in chronic rhinosinusitis (CRS) and paranasal sinus cyst was evaluated. A retrospective validation study. A total of 122 patients (195 sinuses) who underwent ESS in Okayama University Hospital in 2012 were enrolled. The relationships between the ESS classification and the clinical course, including the operation time, bleeding amounts during surgery and postoperative changes of olfaction, the computed tomography (CT) score, and nasal airway resistance were analyzed. A total of 195 ESS procedures were classified into type I (n = 3), type II (n = 17), type III (n = 91), type IV (n = 82), and type V (n = 2). The major phenotypes of type II, III, and IV ESS were paranasal sinus cyst (68%), CRS without nasal polyps (77%), and CRS with nasal polyps (55%), respectively, and the difference was significant. The degree of ESS based on this classification was positively and significantly correlated with the operation time and bleeding amounts. As a whole, olfaction, CT score, and nasal airway resistance were significantly improved after surgery. The degree of improvement was similar between type III and type IV ESS. This simple classification for ESS reflected the perioperative burden of the disease.