Sinonasal Outcomes After Endoscopic Sinus Surgery in Asthmatic Patients With Nasal Polyps: A Difference Between Aspirin-Tolerant and Aspirin-Induced Asthma?
Sinonasal Outcomes After Endoscopic Sinus Surgery in Asthmatic Patients With Nasal Polyps: A Difference Between Aspirin-Tolerant and Aspirin-Induced Asthma?
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DOI：
10.1097/mlg.0b013e318170af1e
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发表时间：
2008-07-01
期刊：
影响因子：
2.6
通讯作者：
Graham, Scott M.
中科院分区：
文献类型：
--
作者：
Awad, Osama G.;Lee, John H.;Graham, Scott M.
目的/假设：阿司匹林敏感性、哮喘和鼻息肉病（NP）构成Samter三联征的临床实体。本研究的目的是报告鼻内窥镜手术（ESS）治疗哮喘患者NP的结果，比较阿司匹林诱导的哮喘（AIA）患者与阿司匹林耐受性哮喘（ATA.Study Design：Retrospective ChartReview.Methods：66例NP和哮喘患者的记录进行了回顾性分析。将41名AIA患者与25名ATA患者进行了比较。对于每例患者，计算术前扫描的Lund-Mackay计算机断层扫描（CT）评分和18个月内可用的术后CT扫描，并将其用作主要终点。鼻窦改善患者评估和报告的症状量表作为次要终点比较术前6个月和12个月后的ESS.Results：术前CT评分AIA患者与ATA患者相比，分别显着高于19（标准差，4.82）与14（标准差，6.8），分别（P = 0.006）。这种差异在术后CT扫描中持续存在（P <0.0001）。在18个月随访期间，63.4%的AIA患者与96%的ATA患者的CT改善，两组之间存在统计学显著差异（P = .003）。在ESS后6个月，63.4%的AIA患者和56%的ATA患者症状改善。12个月时，68.3%的AIA患者与60%的ATA患者有症状改善，两组之间无显著差异。结论：AIA患者有更广泛的鼻窦疾病比ATA患者。两组在ESS后的鼻窦结局均有统计学显著改善。两组患者的CT改善差异具有统计学显著性，AIA患者的CT评分更差。
Objectives/Hypothesis: Aspirin-sensitivity, asthma, and nasal polyposis (NP) comprise the clinical entity of Samter's triad. The aim of this study is to report the sinonasal outcomes of endoscopic sinus surgery (ESS) in treating NP in asthmatic patients, comparing aspirin-induced asthmatic (AIA) patients with aspirin-tolerant asthmatics (ATA).Study Design: Retrospective chart review.Methods: The records of 66 patients with NP and asthma were retrospectively reviewed. Forty-one AIA patients were compared with 25 ATA patients. For each patient, a Lund-Mackay computed tomography (CT) score of the preoperative scans and the available postoperative CT scans in a period of 18 months were calculated and used as primary endpoint. Sinonasal improvement assessed by patients and reported with a symptoms scale was used as the secondary endpoint for the comparison immediately before surgery and 6 months and 12 months following ESS.Results: Preoperative CT scores in AIA patients compared with ATA patients were significantly higher 19 (standard deviation, 4.82) vs. 14 (standard deviation, 6.8), respectively (P =.006). This difference was sustained for the available postoperative CT scans (P < .0001). During the period of 18 months follow-up, 63.4% of AIA patients vs. 96% of ATA patients had CT improvement with a statistically significant difference between the two groups (P = .003). At 6 months following ESS, 63.4% ofAIA patients vs. 56% of ATA patients had symptomatic improvement. At 12 months, 68.3% of AIA patients vs. 60% of ATA patients had symptomatic improvement, with no significant difference between the two groups.Conclusion: AIA patients had more extensive sinonasal disease than ATA patients. Both groups showed statistically significant improvement in sinonasal outcomes after ESS. The difference between the two groups was statistically significant for patients' CT improvement with worse CT scores being seen in AIA patients.