Chirurgická léčba nosní polypózy
Část III.: Symptomatické hodnocení efektu operace

Česká verzia

Authors: B. Gál; P. Smilek
Authors place of work: Klinika otorinolaryngologie a chirurgie hlavy a krku FN u sv. Anny, Brno přednosta prof. MUDr. R. Kostřica, CSc.
Published in the journal: Otorinolaryngol Foniatr, 60, 2011, No. 4, pp. 192-197.
Category: Original Article

Summary

The authors presents results of questionnaires aimed at subjective evaluation of success of nasal polyposis surgical treatment. Valid data were obtained from 63 patients operated on for bilateral nasal polyposis in the Department of Otorhinolaryngology and Head and Neck Surgery of St. Anne’s University Hospital Brno between 1998 and 2005. Three years after the surgery, the patients received a questionnaire a part of which was subjective evaluation of 4 essential symptoms according to the degree of patient complaints before the surgery and afterwards. The visual analogue scale was used (where 0 means the lowest degree of satisfaction and 10 the highest one) for classification of the degree of subjectively perceived symptoms. Symptomatic improvement expressed as an average of differences in VAS score values before the surgery and afterwards was in nasal obstruction 6.59 ± 1.98 (79%), nasal discharge 4.97 ± 2.18 (65%), smell disorders 4.94 ± 3.93 (63%) and facial pressure and headache evaluation 2.86 ± 2.33 (72%). The total degree of patient satisfaction with the surgery result expressed with the average value of VAS score was 8.2 ± 1.77.

Key words:
nasal polyps, surgical treatment, symptomatic assessment, VAS score.

Zdroje

1. Bachert, C., Gevaert, P., Holtappels, G., Johansson, S. G., van Cauwenberge, P. L.: Total and specific IgE in nasal polyps is related to local eosinophilic inflammation. J. Allergy Clin. Immunol., 107, 2001, 4, s. 607-614.

2. Bhattacharyya, N., Darshan, K., Fechner, F., Gliklich, R., Metson, R.: Tissue eosinophilia in chronic sinusitis: Quantification techniques. Arch. Otolaryngol. Head Neck Surg., 127, 2001, 1, s. 1002-1105.

3. Caplin, I., Haynes, T. J., Spahn, J.: Are nasal polyps an allergic phenomenon ? Ann. Allergy, 29, 1971, s. 631-634.

4. Dalziel, K., Stein, K., Round, A., Garside, R., Royle, P.: Systematic review of endoscopic sinus surgery for nasal polyps. Health Technik. Assess, 7, 2003, s. 1-159.

5. Danielsen, A., Olofsson, J.: Endoscopic endonasal sinus surgery. A long-term follow-up study. Acta Otolaryngol., 116, 1996, 4, s. 611-619.

6. Drake-Lee, A.: Nasal polyps. In: Mygind, N., Naclerio, R. M. (editor): Allergic and non-allergic rhinitis. Kopenhagen, Munksgaard, 1993.

7. Elwany, S., Bassyouni, M., Morad, F.: Some risk factors for refractory sinusitis: an immunohistochemical and electron microscopic study. J. Laryngál. Otol, 116, 2002, s. 112-115.

8. Fokkens, W. J., Lund, V. J., Mullol, J. et al.: European position paper on nasal polyps. Rhinology, 45, 2007 (suppl.), 20, s. 1-139.

9. Harlin, S. L., Ansel, D. G., Lane, S. L., Myers, J., Kephart, G. M., Gleich, G. J.: A clinical and pathological study of chronic sinusitis: the role of the eosinophil. J. Allergy Clin. Immunol., 81, 1988, s. 867-875.

10. Hellquist, H.: Nasal polyps update. Histopathology. Allergy Asthma Proc., 17, 1996, s. 237-242.

11. Jakobsen, J., Svendstrup, F.: Functional endoscopic sinus surgery in chronic sinusitis – a series of 237 consecutively operated patients. Acta Otolaryngol. Suppl., 543, 2000, s. 158-161.

12. Jankowski, R., Bouchoua, F., Coffinet, L., Vignaud, J. M.: Clinical factors influencing the eosinophil infiltration of nasal polyps. Rhinology, 40, 2002, s. 173-178.

13. Jankowski, R., Pigret, D., Decroocq, F.: Comparison of functional results after ethmoidectomy and nasalization for diffuse and severe nasal polyposis. Acta Otolaryngol. 117, 1997, s. 601-608.

14. Kennedy, D. W.: Prognostic factors, outcomes and staging in ethmoid sinus surgery. Laryngoskope, 102, 1992 (12 Pt 2 Suppl. 57), s. 1-18.

15. Kern, R. A., Schenck, H. P.: Allergy, a constant factor in the etiology of socalled mucous nasal polyps. J. Allergy, 1933, s. 48597.

16. Kuchyňková, Z.: Nosní polypy. Galén, 2003. ISBN 80-7262-198-X, 100.

17. Kurent, Z., Zargi, M.: Endoscopic polypectomy vs. endoscopic ethmoidectomy in combined treatment of massive bilateral nasal polyposis. In ERS & ISIAN Meeting ’98, 1998, s. 187-190.

18. Larsen, K.: The clinical relationship of nasal polyps to asthma. Allergy Asthma Proc., 17, 1996, s. 243-249.

19. Lund, V. J., Mackay, I. S.: Staging in rhinosinusitus. Rhinology, 31, 1993, 4, s. 183-184.

20. Mullol, J., Roca-Ferrer, J., Xaubet, A., Raserra, J., Picado, C.: Inhibition of GM-CSF secretion by topical corticosteroids and nedocromil sodium. A comparison study using nasal polyp epithelial cells. Respir. Med., 94, 2000, 5, s. 428-431.

21. Mullol, J., Xaubet, A., Lopez, E., Roca-Ferrer, J., Picado, C.: Comparative study of the effects of different glucocorticosteroids on eosinophil survival primed by cultured epithelial cell supernatants obtained from nasal mucosa and nasal polyps. Torax, 50, 1995, 3, s. 270-274.

22. Newman, L. J., Platts-Mills, T. A., Phillips, C. D. et al.: Chronic sinusitis: relationship of computed tomographic findings to allergy, asthma, and eosinophilia. JAMA, 271, 41994, s. 363-367.

23. Penttilä, M., Rautiainen, M., Pukander, J., Kataja, M.: Functional vs. radical maxillary surgery. Failures after functional endoscopic sinus surgery. Acta Otolaryngol., 529, (Suppl. 1997), 173-176.

24. Perkins, J. A., Blakeslee, D. B., Andrade, P.: Nasal polyps: a manifestation of allergy? Otolaryngol. Head Neck Surg., 101, 1989, s. 641-645.

25. Settipane, G.: Epidemiology of nasal polyps. In: Settipane, G., Lund, V. J., Bernstein, J. M., Tos, M. (editor): Nasal polyps: epidemiology, pathogenesis and treatment. Rhode Island Oceanside Publications, 1997, s. 17-24.

26. Settipane, G. A., Chafee, F. H., Klein, D. E.: Aspirin intolerance II. A prospective study in an atopic and normal population. J. Allergy Clin. Immunol., 53, 1974, 4), s. 200-204.

27. Settipane, G. A, Chafee, F. H.: Nasal polyps in asthma and rhinitis. A review of 6,037 patients. J. Allergy Clin. Immunol., 59, 1977, s. 17-21.

28. Sobol, S. E., Wright, E. D., Frenkiel, S.: One-year outcome analysis of functional endoscopic sinus surgery for chronic sinusitis. J. Otolaryngol., 27, 1998, s. 252-257.

29. Song, J. I., Chopra, R., Yao-Shi, F., Calcaterra, T. C.: Predicting surgical failure and disease recurrence in chronic inflammatory sinus disease through histopathology [abstract]. Am. Acad. Otolaryngol. Head Neck Surg., 113, 1995, s. 58.

30. Stammberger, H.: Surgical treatment of nasal polyps: Past, present, and future. Allergy, 54, 1999, s. 7-11.

31. Stoop, A. E., Van Der Heijden, H. A., Biewenga, J., Van Der Baan, S.: Clinical aspects and distribution of immunologically active cells in the nasal mucosa of patients with nasal polyps after endoscopic sinus surgery and treatment with topical corticosteroids. Eur Arch. Otorhinolaryngol., 249, 1992, s. 313-317.

32. Szczeklik, A., Stevenson, D. D.: Aspirin-induced asthma: advances in pathogenesis and management. J. Allergy Clin. Immunol., 104, 1999, s. 5-13.

33. Szucs, E., Ravandi, S., Goossens, A., Beel, M., Clement, P. A.: Eosinophilia in the ethmoid mucosa and its relationship to the severity of inflammation in chronic rhinosinusitis. Am. J. Rhinol., 16, 2002, 3, s. 131-134.

34. Venkatachalam, V. P., Bhat, A.: Comparative evaluation of endoscopic and conventional surgical techniques in the management of nasal polyposis. J. K. Pract., 1998, 5, s. 295-299.

35. Vento, S. I., Ertama, L. O., Hytonen, M. L., Wolff, Ch., Mainberg, Ch.: Nasal polyposis: Clinical course during 20 years. Ann. Allergy, Asthma Immunol., 85, 2000, s. 209-214.

36. Vokurka, J., Šlapák, I., Hybášek, I.: Endoskopické endonazální operace. Sborník prací LF v Brně. ISBN 80-210-1957-3. 116.

37. Watelet, J. B., Annicq, B., Van Cauwenberge, P., Bachert, C.: Objective outcome after functional endoscopic sinus surgery: Prediction factors. The Laryngoscope, 114, s. 1092-1097.

38. Weber, R., Draf, W., Keerl, R., Schick, B., Saha, A.: Endonasal microendoscopic pansinusoperation in chronic sinusitis II. Results and complications. Am. J. Otolaryngol., 18, 199, s. 247-253.

39. Wigand, M. E., Hosemann, W.: Microsurgical treatment of recurrent nasal polyposis. Rhinol., 1989, s. 825‑829.

40. Xaubet, A., Mullol, J., Roca-Ferrer, J., Pujols, L., Fuentes, M., Perez, M. et al.: Effect of budesonide and nedocromil sodium on IL-6 and IL-8 release from human nasal mucosa and polyp epithelial cells. Respir. Med., 95, 2001, 5, s. 408-414.