Brazilian Journal of Otorhinolaryngology最新文献_第9页

Ectopic cervical thymic cyst with thyroglossal duct cyst 异位颈胸腺囊肿合并甲状舌管囊肿

IF 2.2 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-04-02 DOI: 10.1016/j.bjorl.2024.101431

Weiyao Chen , Juxing Sun , Yanqiu Zhou , Mengyin Li , Shaohua Wang , Xinxin Yang , Xiaoyu Li

引用次数: 0

Degree of swallowing impairment in the elderly: clinical and instrumental assessment 老年人的吞咽障碍程度：临床和仪器评估

IF 2.2 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-03-25 DOI: 10.1016/j.bjorl.2024.101426

Tatiane Totta Salgado , Cris Magna dos Santos Oliveira , Marina Gatti , Roberta Gonçalves da Silva , Heitor Marques Honório , Giédre Berretin-Felix

Objective

To classifying the degree of swallowing impairment in the elderly, comparing clinical and instrumental assessment.

Methods

This is a cross-sectional study with quantitative and qualitative analysis of clinical and instrumental assessment of 37 elderly, aged 60–82 years, of both genders without neurological, oncological or systemic diseases, participated in this study. All participants were submitted to clinical evaluation and their results compared through fiberoptic endoscopic evaluation of swallowing considering liquid, pudding and solid food consistencies. Data were analyzed descriptively and statistically using the analysis of variance test (two-way ANOVA) and Tukey's post hoc test (p <  0.05).

Results

In the clinical evaluation there was a higher occurrence of moderate swallowing impairment, followed by functional swallowing, while in fiberoptic endoscopic evaluation of swallowing the severity of the impairment was greater for moderate and mild degrees. There was no statistical difference between the clinical and instrumental evaluation methods. However, there was a significant interaction between the variables, with a difference for liquid consistency in the instrumental evaluation method.

Conclusion

Healthy elderly have different degree of swallowing impairment according to food consistency. The clinical assessment using a scale that considers the physiological changes of the elderly, presented results similar to those found in the instrumental examination.

Level of Evidence

2.

方法这是一项横断面研究，对 37 名年龄在 60-82 岁之间、无神经系统、肿瘤或全身性疾病的男女老年人的临床和仪器评估结果进行定量和定性分析。所有参与者都接受了临床评估，并通过纤维内窥镜对液体、布丁和固体食物的吞咽情况进行了评估，对评估结果进行了比较。结果在临床评估中，中度吞咽障碍的发生率较高，其次是功能性吞咽，而在纤维内窥镜吞咽评估中，中度和轻度吞咽障碍的严重程度更高。临床和仪器评估方法之间没有统计学差异。结论健康老人的吞咽功能障碍程度因食物的浓稠度而异。临床评估使用的量表考虑了老年人的生理变化，其结果与仪器检查的结果相似。

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引用次数: 0

Clinical experience of an adhesive bone conduction hearing system in children with congenital single-sided deafness 粘合式骨导听力系统在先天性单侧耳聋儿童中的临床经验

IF 2.2 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-03-25 DOI: 10.1016/j.bjorl.2024.101427

Yujie Liu , Wenxi Qiu , Lin Yang , Yuan Wang , Jikai Zhu , Mengshuang Lv , Shouqin Zhao

Objectives

This study aimed to investigate the effects of an adhesive bone conduction device (aBCD) in children with congenital single-sided deafness (SSD). Specifically, we examined whether the aBCD elicits improvement in the speech perception ability of children with congenital SSD and whether using this device would adversely affect the horizontal localisation abilities of these children.

Methods

Thirteen school-aged children with SSD and seven children with Normal Hearing (NH) were included in this study. Speech perception in noise was measured using the Mandarin Speech Test Materials and sound localisation performance was evaluated using broadband noise stimuli (0.5–20 kHz), randomly played from seven loudspeakers at different stimulus levels (65-, 70-, and 75-dB SPL).

Results

All children with SSD showed inferior speech perception and sound localisation performance compared with children with NH. The aBCD use remarkably improved the speech perception abilities of these children under quiet and noise conditions; however, their sound localisation abilities neither improved nor deteriorated.

Conclusion

This study reveals the effectiveness and safety of a non-surgical aBCD in paediatric patients with SSD. Our results provide a theoretical basis for early hearing intervention with an aBCD in children with congenital SSD who are temporarily unable to undergo ear surgery.

Level of evidence

Level 3.

目的本研究旨在调查粘附式骨传导装置（aBCD）对先天性单侧耳聋（SSD）儿童的影响。具体而言，我们研究了骨传导粘合装置是否能改善先天性单侧耳聋儿童的言语感知能力，以及使用该装置是否会对这些儿童的水平定位能力产生不利影响。结果与正常听力儿童相比，所有患有 SSD 的儿童在语音感知和声音定位能力方面都较差。在安静和噪音条件下，使用 aBCD 显著提高了这些儿童的言语感知能力；但是，他们的声音定位能力既没有提高，也没有降低。我们的研究结果为暂时无法接受耳科手术的先天性SSD患儿使用口腔内窥镜助听器进行早期听力干预提供了理论依据。

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引用次数: 0

Postoperative complications in cochlear implant surgery and their possible risk factors 人工耳蜗植入手术的术后并发症及其可能的风险因素

IF 2.2 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-03-25 DOI: 10.1016/j.bjorl.2024.101428

Vanessa Ribeiro Orlando , Oswaldo Laércio Mendonça Cruz

Objective

This is a retrospective analysis of the major and minor complications of cochlear implants, as well as the Risk Factors (RF) involved.

Methods

We analyzed the medical records of patients submitted to cochlear implants at public University from 2006 to July 2019, and list here the major and minor complications found, and their risk factors.

Results

There were 193 ears, 100 (51.3%) from females and 93 (48.2%) from males, with a mean age of 23.63 years. In 54 of them (28%), there were alterations seen in the Temporal Bone CT scan, and 44 (22.8%) in the brain MRI. There were 158 (81.9%) insertions performed; 127 (65.8%) of them through the round window. There were 78 complications: 19 (9.8%) major and 56 (29%) minor complications. Among the major complications, there were 3 (1.6%) Surgical Site infections (SS); 5 (2.6%) hematomas/seromas; 5 (2.6%) electrode extrusion; 5 (2.6%) device faults; 1 (0.5%) wrong path. Among the minor complications, there were 6 (3.1%) Acute Otitis Media (AOM); 9 (4.7%) SS infections; 4 (2.1%) facial paresis; 17 (8.8%) vertigos; 9 (4.7%) with tinnitus. The most important RF was age. Patients younger than 2.5 years had more major complications: SS infection (p = 0.018) and electrode extrusion (p = 0.017). There was a higher rate of vertigo in adults (p = 0.003), and it was more often associated with comorbidities (p = 0.008). The insertion route, the presence of changes in CT and MRI and the CI brand used did not impact the number of complications.

Conclusion

Among the minor complications, those involving the vestibular system were the most common, especially in adults with comorbidities. Regarding major complications, there was an emphasis on SS infections, hematomas, seromas, electrode extrusion, especially in children under two years of age. There were implanted device faults (2.6%), with none of the brands evaluated standing out.

方法我们分析了2006年至2019年7月在公立大学接受人工耳蜗植入术的患者病历，并在此列出了发现的主要和次要并发症及其风险因素。其中 54 人（28%）在颞骨 CT 扫描中发现异常，44 人（22.8%）在脑磁共振成像中发现异常。共进行了 158 例（81.9%）植入手术，其中 127 例（65.8%）通过圆窗植入。共出现 78 例并发症：19例（9.8%）为严重并发症，56例（29%）为轻微并发症。在主要并发症中，有 3 例（1.6%）手术部位感染（SS）；5 例（2.6%）血肿/血丝瘤；5 例（2.6%）电极挤出；5 例（2.6%）设备故障；1 例（0.5%）路径错误。在轻微并发症中，急性中耳炎（AOM）6 例（3.1%）；SS 感染 9 例（4.7%）；面瘫 4 例（2.1%）；眩晕 17 例（8.8%）；耳鸣 9 例（4.7%）。最重要的病因是年龄。年龄小于 2.5 岁的患者有更多的主要并发症：SS 感染（p = 0.018）和电极挤压（p = 0.017）。成人的眩晕发生率更高（p = 0.003），而且更常见于合并症（p = 0.008）。在轻微并发症中，涉及前庭系统的并发症最为常见，尤其是在有合并症的成年人中。关于主要并发症，重点是 SS 感染、血肿、血清肿、电极挤出，尤其是两岁以下儿童。植入设备出现故障（2.6%），所评估的品牌无一突出。

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引用次数: 0

Cochlear implantation outcomes in children with multiple disabilities: a topic that’s worth revisiting 多重残疾儿童的人工耳蜗植入效果：一个值得重新审视的话题

IF 2.2 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-03-21 DOI: 10.1016/j.bjorl.2024.101423

Goh Bee-See , Nur Af’Idah Mohd Zulkefli , Asma Abdullah , Cila Umat , Norazlin Kamal Nor , Juriza Ismail , Stephen J. O’Leary

Objectives

To determine the benefits of cochlear implantation in hearing loss children with multiple disabilities (MD) in terms of auditory outcomes, speech performance, and their quality of life.

Methods

This was a cross sectional study from January 2019 to December 2020 in which thirty-one children with hearing loss and multiple disabilities were evaluated. Their improvement in auditory and speech performances were assessed using Categories of Auditory Performance version II (CAP-II) and the Speech Intelligibility Rating (SIR) scales. The assessment was done at 6-month intervals, with the baseline evaluation done at least six months after activation of the implant. Parents were asked to fill the Parents Evaluation of Aural/Oral Performance of Children (PEACH) diary and Perceived Benefit Questionnaire (PBQ) to evaluate the child’s quality of life.

Results

All 31 children have Global Developmental Delay (GDD), with 11 having an additional disability. Both mean CAP-II and SIR scores showed significant improvement with increased hearing age (p < 0.05) after 6-month intervals. In addition, 20 out of 31 children (64.5%) have achieved verbal communication after implantation. The mean PEACH score in quiet was significantly better than in noise (p = 0.007) and improved with the increased of hearing age. The majority of parents (96%‒100%) perceived a cochlear implant as beneficial to their child in terms of auditory response, awareness, interaction, communication, and speech development.

Conclusions

Cochlear implantation had shown benefits in children with multiple disabilities. Outcome measures should not only focus on auditory and speech performances but the improvement in quality of life. Hence, individualized each case with realistic expectation from families must be emphasized in this group of children.

Level of evidence

Level 3.

目的确定人工耳蜗植入对听力损失和多重残疾（MD）儿童在听觉结果、言语表现和生活质量方面的益处。方法这是一项横断面研究，从2019年1月至2020年12月，对31名听力损失和多重残疾儿童进行了评估。他们的听觉和言语表现的改善情况使用听觉表现分类 II（CAP-II）和言语清晰度评分（SIR）量表进行评估。评估每 6 个月进行一次，基线评估至少在植入手术后 6 个月进行。家长被要求填写 "儿童听力/口腔表现家长评估（PEACH）日记 "和 "感知益处问卷（PBQ）"，以评估儿童的生活质量。6 个月后，随着听力年龄的增加，CAP-II 和 SIR 平均得分均有显著提高（P < 0.05）。此外，31 名儿童中有 20 名（64.5%）在植入后实现了语言交流。安静时的 PEACH 平均得分明显优于噪音时（p = 0.007），并随着听力年龄的增加而提高。大多数家长（96%-100%）认为人工耳蜗植入对孩子的听觉反应、认知、互动、交流和言语发展有益。衡量成果的标准不应仅关注听觉和言语表现，还应关注生活质量的改善。因此，对于这类儿童，必须强调每个病例的个性化和家庭的实际期望。

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引用次数: 0

Internal jugular vein thrombosis caused by invasive pharyngeal cancer: a case report and literature review 浸润性咽癌导致的颈内静脉血栓：病例报告和文献综述

IF 2.2 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-03-21 DOI: 10.1016/j.bjorl.2024.101425

Filip Tudor , Andro Košec , Alan Pegan

引用次数: 0

Chronic rhinosinusitis possibly associated with decreased lung function in chronic cough patients 慢性鼻炎可能与慢性咳嗽患者肺功能下降有关

IF 2.2 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-03-21 DOI: 10.1016/j.bjorl.2024.101424

Pengfei Zhao , Shin Kariya , Takaya Higaki , Seiichiro Makihara , Toru Rikimaru , Mitsuhiro Okano , Mizuo Ando

Objectives

The purpose of this study is to investigate the lung function in Chronic Rhinosinusitis (CRS) patients with Chronic Cough (CC).

Methods

A total of 1413 CC patients were retrospectively screened and 109 CRS patients with CC were enrolled. Lung function, Lund-Mackay Computed Tomography (CT) score, smoking status, peripheral blood eosinophil count, and immunoglobulin E concentration in serum samples, and Sino-Nasal Outcome Test were examined. Normal control subjects are also recruited.

Results

The Forced Expiratory Volume in 1 second (FEV_1.0), Percent Predicted FEV_1.0, and FEV_1.0/Forced Vital Capacity (FVC) ratio in the patients were significantly low as compared with the control subjects. The FEV_1.0/FVC ratio was negatively correlated with the Lund-Mackay CT scores of the patients with a high CT score.

Conclusions

The CRS patients with CC should be investigated with lung function. In addition, the multidisciplinary evaluation including a pulmonologist is needed to manage the CRS patients with CC.

Level of evidence

Level 4.

方法对 1413 名慢性鼻窦炎（CRS）患者进行回顾性筛查，并纳入 109 名慢性鼻窦炎（CRS）合并慢性咳嗽（CC）患者。方法对 1413 名 CC 患者进行回顾性筛选，并纳入 109 名 CRS CC 患者，对他们的肺功能、Lund-Mackay 计算机断层扫描（CT）评分、吸烟状况、外周血嗜酸性粒细胞计数、血清样本中免疫球蛋白 E 的浓度以及中鼻结果测试进行检查。结果与对照组相比，患者的 1 秒用力呼气容积（FEV1.0）、预测 FEV1.0 百分比和 FEV1.0/ 强迫生命容量（FVC）比值明显偏低。FEV1.0/FVC比值与CT评分高的患者的Lund-Mackay CT评分呈负相关。此外，还需要进行包括肺科医生在内的多学科评估，以管理伴有 CC 的 CRS 患者。

{"title":"Chronic rhinosinusitis possibly associated with decreased lung function in chronic cough patients","authors":"Pengfei Zhao , Shin Kariya , Takaya Higaki , Seiichiro Makihara , Toru Rikimaru , Mitsuhiro Okano , Mizuo Ando","doi":"10.1016/j.bjorl.2024.101424","DOIUrl":"10.1016/j.bjorl.2024.101424","url":null,"abstract":"<div><h3>Objectives</h3><p>The purpose of this study is to investigate the lung function in Chronic Rhinosinusitis (CRS) patients with Chronic Cough (CC).</p></div><div><h3>Methods</h3><p>A total of 1413 CC patients were retrospectively screened and 109 CRS patients with CC were enrolled. Lung function, Lund-Mackay Computed Tomography (CT) score, smoking status, peripheral blood eosinophil count, and immunoglobulin E concentration in serum samples, and Sino-Nasal Outcome Test were examined. Normal control subjects are also recruited.</p></div><div><h3>Results</h3><p>The Forced Expiratory Volume in 1 second (FEV<sub>1.0</sub>), Percent Predicted FEV<sub>1.0</sub>, and FEV<sub>1.0</sub>/Forced Vital Capacity (FVC) ratio in the patients were significantly low as compared with the control subjects. The FEV<sub>1.0</sub>/FVC ratio was negatively correlated with the Lund-Mackay CT scores of the patients with a high CT score.</p></div><div><h3>Conclusions</h3><p>The CRS patients with CC should be investigated with lung function. In addition, the multidisciplinary evaluation including a pulmonologist is needed to manage the CRS patients with CC.</p></div><div><h3>Level of evidence</h3><p>Level 4.</p></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"90 4","pages":"Article 101424"},"PeriodicalIF":2.2,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1808869424000399/pdfft?md5=3d0be4a5955f4c8b6dadc16514180564&pid=1-s2.0-S1808869424000399-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140272979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comprehensive analysis of the immune implication of EPHX4 gene in laryngeal squamous cell carcinoma 全面分析EPHX4基因在喉鳞癌中的免疫影响

IF 2.2 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-03-07 DOI: 10.1016/j.bjorl.2024.101411

Nimei Shen , Gang Gao , Xinhong Lu, Jiaxin Jin, Liwei Lin, Maohua Qian, Yang Qin

Objectives

The role of Epoxide Hydrolase-4 (EPHX4), a member of epoxide hydrolase family, has not been investigated in cancer. The purpose of this article is to explore the application value of EPHX4 in laryngeal cancer and its relationship with immune infiltration.

Methods

We observed that EPHX4 expression and its survival assays in laryngeal cancer specimens based on The Cancer Genome Atlas (TCGA) cohorts. We also analyzed the correlation between immune cell infiltration levels and EPHX4 gene copy number in laryngeal cancer. Finally, we conducted in vitro assay to evaluate the functions of EPHX4 in laryngeal cancer cell line.

Results

EPHX4 is highly expressed in laryngeal cancer specimens and has a poor prognosis. EPHX4 related immune cell analysis showed that it participated in NK Natural killer cell mediated cytotoxicity. Finally, Cell experiments indicate that EPHX4 could promote laryngeal cancer cell line proliferation, colony formation and invasion.

Conclusions

Our research results suggest that EPHX4 may be a potential immunotherapy target for laryngeal cancer. The nominated immune signature is a helpful and promising prognostic indicator in laryngeal cancer.

Levels of Evidence

Level 3.

目的环氧化物水解酶家族成员之一环氧化物水解酶-4（EPHX4）在癌症中的作用尚未得到研究。本文旨在探讨 EPHX4 在喉癌中的应用价值及其与免疫浸润的关系。方法我们观察了基于癌症基因组图谱（TCGA）队列的喉癌标本中 EPHX4 的表达及其生存测定。我们还分析了喉癌中免疫细胞浸润水平与 EPHX4 基因拷贝数之间的相关性。结果EPHX4在喉癌标本中高表达，且预后较差。与 EPHX4 相关的免疫细胞分析表明，它参与了 NK 自然杀伤细胞介导的细胞毒性。最后，细胞实验表明，EPHX4 可促进喉癌细胞株的增殖、集落形成和侵袭。我们的研究结果表明，EPHX4 可能是喉癌的潜在免疫治疗靶点。提名的免疫特征是喉癌的一个有用且有前景的预后指标。

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引用次数: 0

The variations of osseous structure of the ınternal acoustic canal: an anatomical study 外耳道骨性结构的变化：一项解剖学研究

IF 2.2 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-03-05 DOI: 10.1016/j.bjorl.2024.101414

Elif Sarı , Gkionoul Nteli Chatzioglou , Dastan Temirbekov , Aynur Aliyeva , Adnan Öztürk , Ilke Ali Gürses

Objectives

The internal acoustic meatus is an osseous canal that connects the inner ear to the posterior cranial fossa. It is located in the petrous portion of the temporal bone. A thin cribriform osseous plate known as the fundus is situated at the lateral end of the canal. This study assesses the structural and numerical variations of the fundus formations.

Methods

Fifty-four temporal bones of unknown gender and age were examined with the surgical microscope.

Results

The temporal bones analyzed were 46.2% right-sided and 53.7% left-sided. Only one temporal bone had two parallel transverse crests, while three had a single anterior crest that split into two branches posteriorly. The number of foramina at the transverse crest varied, with 29.6% having none, 48.1% having a single foramen, and 22.2% having several foramina. An anterior crest structure was seen in 53.7% of the temporal bones, with 5% having a slightly constricted entry to the facial canal. In cases with a single nerve foramen, 48.1% had one, while 51.8% had more than one, including examples with three or four foramina. A crest was found between the foramina of the single nerve in 7% of patients. Furthermore, a crest between the saccular nerve foramen and the high fiber foramina was seen in 25.9% of cases, and 5% had two saccular nerve foramina.

Conclusion

We think that revealing the anatomical, structural and numerical variations in the fundus will be useful in explaining the disease-symptom relationship.

Level of evidence

Level 4.

内听道是连接内耳和后颅窝的骨性管道。它位于颞骨的石质部分。在耳道的外侧端有一块薄薄的楔形骨板，称为耳底。本研究评估了基底形态的结构和数量变化。研究人员用手术显微镜检查了 54 块性别和年龄不详的颞骨。所分析的颞骨中，46.2%为右侧颞骨，53.7%为左侧颞骨。只有一块颞骨有两个平行的横嵴，而三块颞骨只有一个前嵴，后嵴分成两个分支。横嵴上的孔数量各不相同，29.6%没有孔，48.1%有一个孔，22.2%有多个孔。53.7%的颞骨可见前嵴结构，5%的颞骨面神经管入口略有狭窄。48.1%的病例只有一个神经孔，51.8%的病例有多个神经孔，包括有三个或四个神经孔的病例。7%的患者在单神经孔之间发现了嵴。此外，25.9% 的病例在骶神经孔和高纤维孔之间有嵴，5% 的病例有两个骶神经孔。我们认为，揭示眼底的解剖、结构和数字变化将有助于解释疾病与症状之间的关系。第四级

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引用次数: 0

Efficacy of the posterior nasal nerve resection combined with hormone transnasal nebulization on difficult-to-treat rhinosinusitis: a retrospective analysis 鼻后神经切除术联合经鼻激素雾化治疗难治性鼻炎的疗效：回顾性分析

IF 2.2 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-03-01 DOI: 10.1016/j.bjorl.2024.101413

Xin-ke Wang , Qi-ling Zheng , Jia-ning Sun

Objective

A retrospective analysis was performed to explore the clinical effect of the Posterior Nasal Nerve (PNN) resection combined with hormone transnasal nebulization on Difficult-to-Treat Rhinosinusitis (DTRS).

Methods

A total of 120 DTRS patients were selected and divided into a control group (n = 60) and a study group (n = 60) according to different treatments. The control group patients were treated via PNN resection, followed by normal saline transnasal nebulization; the study group patients were given PNN resection and then treated with budesonide suspension transnasal nebulization. Subsequently, the comparison was performed between the two groups in terms of (1) Clinical baseline characteristics; (2) Sino-nasal Outcome Test (SNOT)-22 scores before treatment and after 3-months, 6-months and 12-months of treatment; (3) Lund-MacKay scores before treatment and after 10, 30, 90, and 180 days of treatment; (4) Incidence of adverse reactions during treatment.

Results

There was no significant difference in SNOT-22 or Lund-Kennedy scores between the two groups before treatment (p > 0.05). After treatment, the SNOT-22 and Lund-Kennedy scores of the control and the study groups were decreased, and compared with the control group, the SNOT-22 and Lund-Kennedy scores in the study group improved more significantly (p < 0.05). In addition, the study group and the control group presented with 1 and 4 cases of nasal adhesion, 2 and 3 cases of epistaxis, 1 and 4 cases of sinus orifice obstruction, 1 and 3 cases of lacrimal duct injuries, respectively. The incidence of adverse reactions in the study group was significantly lower than that in the control group (8.3% vs. 23.3%) (p < 0.05).

Conclusion

PNN resection combined with hormone transnasal nebulization treatment can improve the symptoms and quality of life of DTRS patients, with good clinical efficacy but few adverse reactions. Therefore, such combination treatment deserves a promotion and application clinically.

Level of Evidence

Level 3.

一项回顾性分析旨在探讨鼻后神经（PNN）切除术联合激素经鼻雾化吸入对难治性鼻炎（DTRS）的临床效果。研究人员共选取了 120 例鼻窦炎患者，按照不同的治疗方法将其分为对照组（60 例）和研究组（60 例）。对照组患者接受 PNN 切除术，然后用生理盐水经鼻雾化吸入治疗；研究组患者接受 PNN 切除术，然后用布地奈德混悬液经鼻雾化吸入治疗。随后，两组患者在以下方面进行了比较：(1) 临床基线特征；(2) 治疗前及治疗 3 个月、6 个月和 12 个月后的中鼻结果测试（SNOT）-22 评分；(3) 治疗前及治疗 10 天、30 天、90 天和 180 天后的 Lund-MacKay 评分；(4) 治疗期间的不良反应发生率。治疗前，两组的 SNOT-22 和 Lund-Kennedy 评分无明显差异（> 0.05）。治疗后，对照组和研究组的 SNOT-22 和 Lund-Kennedy 评分均有所下降，与对照组相比，研究组的 SNOT-22 和 Lund-Kennedy 评分改善更为明显（< 0.05）。此外，研究组和对照组分别出现鼻腔粘连 1 例和 4 例、鼻衄 2 例和 3 例、鼻窦口阻塞 1 例和 4 例、泪管损伤 1 例和 3 例。研究组的不良反应发生率（8.3% 对 23.3%）明显低于对照组（< 0.05）。PNN 切除术联合激素经鼻雾化治疗可改善 DTRS 患者的症状和生活质量，临床疗效好，不良反应少。因此，这种联合治疗值得在临床上推广应用。三级。

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引用次数: 0