Socioeconomic Status Impacts the Prognosis of Chronic Rhinosinusitis Treated by Endoscopic Sinus Surgery:An Observational Cohort Study in Northeast China

Objective To explore the association between socioeconomic status(SES)and postoperative outcomes in patients with chronic sinusitis(CRS)after functional endoscopic sinus surgery(ESS).Methods We conducted an observational cohort study of 1,047 patients with CRS undergoing ESS.Discharged patients were followed up to 72 weeks for all-cause recurrence events.Baseline SES was established based on occupation,education level,and family income of the patients 1 year before the operation.Kaplan–Meier method was used to calculate the recovery rate after ESS,and Cox proportional hazards regression analysis was used to evaluate the relationship between SES and prognosis.Results Patients of middle SES had lower unadjusted all-cause recurrence than those of low or high SES;24-week overall recovery rate was 90.4%[95%confidence interval(CI):89.6%–91.2%]in patients of middle SES,13.5%(95%CI:12.8%–14.2%)in patients of low SES,and 31.7%(95%CI:30.7%–32.7%)in patients of high SES(both log-rank P<0.001).After adjustment for covariates,hazard ratios(HRs)were7.69(95%CI:6.17–9.71,Ptrend<0.001)for all-cause recurrence for low SES versus middle SES,and 6.19(95%CI:4.78–7.93,Ptrend<0.001)for middle SES versus high SES.Conclusion Low SES and high SES were more associated with the worse prognosis of CRS patients after ESS than middle SES.

Endoscopic sinus surgery plays an essential role in systematic treatment of odontogenic maxillary sinusitis

Purpose:Odontogenic maxillary sinusitis(OMS)is frequently encountered in otorhinolaryngologists'clinical practice.Endoscopic sinus surgery(ESS)instead of surgeries in intraoral approach has been widely applied among OMS.However appropriate treatments due to the causes of the OMS as well as the outcome have been less investigated,meanwhile the inherent incidence of OMS may be still on the rise.This study was designed to conclude our systematic treatment within follow-up examination.Materials and methods:In this retrospective study patients confirmed diagnosis of OMS who had systematic follow-up examinations were analyzed.Medical histories of otorhinolaryngologists and dentists were reviewed as well as preoperative examination protocols.Result:Consecutive 29 Patients(10 women,19 men)were included.41.4%(12/29)patients experienced facial pain as the most frequent symptom.69.0%(20/29)patients admitted firstly to otorhinolaryngologists,13 patients were treated with surgical procedure while 7 patients lacking of surgical indication were transferred to dentists.31.0%(9/29)patients were advised by dentist for being suspected of maxillary sinusitis,including 7 patients suffered from sinonasal complications of dental treatment(SCDT).Conventional dental treatment(root planning,root end surgery,extraction)was the most common cause.Follow up for a mean of 15.1(ranges from 6 to 96)months showed 29 patients maintaining open maxillary ostium on endoscopic examination or improving on CT except recurrence in one patient with SCDT.Conclusion:Patients should be inspected by dentists carefully when the patient has symptoms rather than sinusitis-like symptoms,the possibility of OMS should always be considered.Dental examination can help to determine whether a maxillary sinusitis has a dental origin,periodontitis and odontogenic radicular cysts still are the most common causes comparing with iatrogenic factors.Patients treated with ESS showed better tolerance and fewer postsurgical complications.Not all patients with OMS including SDCT need definitely surgery whether ESS or intraoral approach,removing dental focus followed with antibiotics would be optimistic choice.

Antibiotic Treatment for Chronic Rhinosinusitis after Endoscopic Surgery: How Long Should Macrolide Antibiotics Be Given?

Background: The purpose of this study was to determine an appropriate period for macrolide antibiotic therapy, and to investigate whether this period could be shorter, for patients with chronicrhino sinusitis (CRS) after functional endoscopic sinus surgery (FESS). Methods: A retrospective analysis of 41 patients undergoing FESS for CRS was performed. All patients underwent pre-operative computed tomography (CT). Patients with fungal sinusitis, allergic fungal sinusitis, and eosinophilic sinusitis were excluded. After FESS, normalized sinus mucosa was confirmed by CT and endoscopy in all patients. Postoperative antibiotic therapy consisted of first-line and second-line regimens. Garenoxacin (GRNX), or clarithromycin (CAM, 400 mg/day) was used as the first-line regimens and low-dose macrolide therapy (CAM, 200 mg/day) was used as the second-line regimen and was prescribed at outpatient visits based on our clinical criteria. Results: Second-line antibiotic therapy (low-dose CAM) was not necessary in 12 of 41 (29%) patients, while it was prescribed in 29 of 41 (71%). The mean duration of low-dose CAM therapy after FESS was 36 days (range 7 to 122 days;median, 25 days). Patients who received second-line therapy (n = 29) were divided into two groups based on the choice of first-line therapy, a GRNX group (n = 13) and a non-GRNX group (n = 16). Those in the non-GRNX had longer periods of postoperative CAM therapy than those in the GRNX group. Conclusion: GRNX was associated with a shorter duration of low-dose macrolide therapy after FESS, and 29% of patients did not need any low-dose macrolide therapy postoperatively. Therefore, macrolide antibiotics should not be routinely prescribed after FESS.

Computed tomography scans of paranasal sinuses before functional endoscopic sinus surgery

This review aims to familiarize the radiologist with the common types of sinus surgery including their indications and techniques.We also illustrate how surgeons interpret 3D sinus anatomy when evaluating computed tomography(CT)studies.Preoperative evaluation by CT is mandatory for all patients undergoing functional endoscopic sinus surgery(FESS).In the past decade in particular,CT of the paranasal sinuses has become a roadmap for FESS.The radiologist's goal is to report on five key points:the extent of sinus opacification,opacification of sinus drainage pathways,anatomical variants,critical variants,and condition of surrounding soft tissues of the neck,brain and orbits.We present a systematic approach to the use of coronal,axial,and sagittal images in CT evaluation before FESS.

Evaluating the Efficacy of Remifentanil-Propofol versus Isoflurane in Reducing Blood Loss with Considering Depth of Anesthesia during Endoscopic Sinus Surgery

Several methods have been suggested to decrease bleeding during surgery, one of which is the usage of hypotensive anesthetic agents. Endoscopic Sinus Surgery (ESS) is one of the surgeries which need a clear field and the amount of bleeding profoundly impacts the ability of surgeons. Current study was designed to evaluate the effect of remifentanil combined with propofol versus Isoflurane on blood loss during ESS and its possible interaction with Depth of Anesthesia. Fifty one patients comprising 15 females and 36 males undergoing ESS were chosen for this study. One group received propofol and remifentanil to induce and maintain anesthesia and the second group received Isoflurane. Mean Arterial Blood Pressure (MAP), Depth of Anesthesia and total blood loss were recorded for the patients of both group. Data were analyzed using t-test, Repeated Measures ANOVA and Pearson’s correlation. P 0.05 was considered statistically significant. Both agents induced hypotension during surgery. No significant difference was observed in total blood loss between two groups. DA was decreased in both groups, but no significant correlation was found between DA and MAP or DA and blood loss. There is no significant difference between remifentanil combined with propofol and Isoflurane in decreasing blood loss during ESS, thus we suggest usage of hypotensive anesthetic agent regardless of its type is ESS.

Lamb's head: The model for novice education in endoscopic sinus surgery

Structured training in endonasal endoscopic sinus surgery(EESS) and skull base surgery is essential considering serious potential complications. We have developed a detailed concept on training these surgical skills on the lamb's head. This simple and extremely cheap model offers the possibility of training even more demanding and advanced procedures in human endonasal endoscopic surgery such as: frontal sinus surgery, orbital decompression, cerebrospinal fluid-leak repair followed also by the naso-septal flap, etc. Unfortunately, the sphenoid sinus surgery cannot be practiced since quadrupeds do not have this sinus. Still, despite this anatomical limitation, it seems that the lamb's head can be very useful even for the surgeons already practicing EESS, but in a limited edition because of a lack of the experience and dexterity. Only after gaining the essential surgical skills of this demanding field it makes sense to go for the expensive trainings on the human cadaveric model.

Cervico-Facial Soft Tissue Emphysema with Pneumo-Mediastinum Following Endoscopic Sinus Surgery: A Dilemma of Related or Unrelated Complication

We present a rare and unusual complication of cervico-facial soft tissue emphysema with pneumo-mediastinum which occurred in a 30-year-old female Jordanian patient in our hospital in October 2010 in Abu Dhabi following FESS. CT scan evaluation of aero-digestive tract in the immediate post-operative period was done to ascertain the cause pertaining to any surgical trauma or anaesthesia related complications. Such a case previously unreported has been included in this study. A simple close monitoring after establishing the cause is usually sufficient in management of such related or unrelated complications during FESS which in our case was likely to be anaesthesia related. Published data of such a complication assists in building up a good and effective medical audit based on ethical practice. This paper stresses the importance of immediate CT scan of aero-digestive tract in evaluating the cause.

Endoscopic Surgical Procedures for Fungal Maxillary Sinusitis: How to Do It, a Review

Fungal rhinosinusitis (FRS) is categorized as being either invasive or non-invasive based on the histopathological evidence of tissue invasion by fungi. Endoscopic sinus surgery (ESS) has become the gold standard treatment for non-invasive FRS including sinus fungal ball. It is considered to be an effective and safe procedure. It is important to keep a sufficient field of view in order to remove the fungal debris completely. ESS should also prevent damage to the nasal cavity structures including the inferior turbinate. This report mainly describes the endoscopic surgical procedures for fungal ball of the maxillary sinus (sinus mycelia) based on our methods and review of the literature, including written articles in Japanese. ESS procedures include the middle meatus approach for the maxillary sinus, the combined approach (both middle and inferior meatal antrostomy) for the maxillary sinus, and endoscopic modified medial maxillectomy (EMMM).

Orbital Injury in Endoscopic Sinus Surgery for Sinonasal Inflammatory Disorders: Juntendo’s Ten-Year Experience

Orbital injury and complications are commonly encountered in endoscopic sinus surgery (ESS) despite advances in techniques and instrumentation. For the recent 10 years, we summarized the experience of the rhinology unit of our department regarding orbital injury and complications of ESS for sinonasal inflammatory disorders. One thousand seventy-three patients (1869 sides) from January 1, 2003 to December 31, 2012 undergoing ESS for sinonasal inflammatory diseases were enrolled in the present study. The age of the patients ranged from 8 to 81 years, mean age 49 years. Orbital injury and complications were observed in 13 patients (13 sides), which corresponded to 0.7% of the operated sides and 1.2% of the patients. Eight patients showed herniation of orbital fat alone through the injury of the lamina papyracea. The protruding orbital fat was snipped and cut using forceps in 2 patients. Removal of exposed orbital fat using powered instruments was performed in 3 patients, two of whom transiently showed periorbital edema postoperatively. No permanent complications were observed. Meticulous preoperative and perioperative planning is critical to prevent orbital complications. Especially, exposure of the periorbit and herniation of orbital fat after lamina injury with powered instrumentation dramatically increases the potential for more severe complications.

Effects of Desloratadine Citrate Disodium combined with Budesonide suspension on serum IgE, EOS and inflammatory factors in patients with CRS after endoscopic sinus surgery

Objective: To observe the clinical application of Desloratadine Citrate Disodium combined with Budesonide suspension in patients with chronic rhinosinusitis CRS after endoscopic sinus surgery, and analyze the change of serum immunoglobulin E (IgE), eosinophils (EOS) and inflammatory factors level in patients. Method: A total of 90 cases of patients with CRS were randomly divided into control group (n=45) and observation group (n=45) according to the lottery method. Both groups were treated with endoscopic sinus surgery. On the basis of this, control group was given Budesonide suspension and observation group was treated with Desloratadine Citrate Disodium combined with Budesonide suspension. The change of serum IgE, EOS and inflammatory factors were measured before and after operation in all subjects. Results: There was no significant difference in IgE and EOS levels between control group and observation group before treatment. After treatment, the levels of serum IgE and EOS in the two groups were significantly lower than those before treatment. Moreover, after treatment, observation group was lower than control group, and the difference was significant. There was no significant difference in inflammatory factors level between control group and observation group before treatment. After treatment, the levels of serum IL-6, IL-8, TNF-α and hs-CRP were significantly lower than those before treatment. After treatment, observation group was lower than the control group in the same period, the difference was significant. Conclusion:Combined Desloratadine Citrate Disodium treatment for CRS patients on the basis of endoscopic sinus surgery and Budesonide Nasal Spray treatment, it can more effectively reduce serum IgE and EOS levels, decrease the inflammatory response. Therefore it was a potential effective treatment for patients with CRS.

The Endonasal Endoscopic Management of Paranasal Sinuses Mucoceles

Introduction: Paranasal sinuses mucoceles are benign, epithelial lined, mucus filled lesions, causing destruction of the adjacent sinus walls, and with further gradual extension to adjacent structures, serious morbidities and mortalities may occur. Objective: To emphasize on the efficacy of endonasal endoscopic marsupialization in the treatment of paranasal sinus mucoceles. Method: Retrospective descriptive study on paranasal sinus mucocele cases operated on endoscopically by the author (AAM), in the 10-year-period from to 2009-2019. Result: Total of 23 cases were included, 16 were males and 7 females, age ranging between 14 - 76 years, with a mean age of 45 years Location of mucoceles varied between: Frontal 7 cases (30%), Fronto-ethmoidal 6 cases (26%), Isolated Ethmoidal accounted for 3 cases (13%), sphenoidal 4 cases (17%), maxillary were 3 cases (13%) all of the 23 cases underwent endonasal endoscopic complete marsupialization, none of them required combination with external approach in-spite of different locations and complications, with no recurrence in a mean follow up period of 2.4 years. Conclusion: Endonasal endoscopic approach is a safe, efficient approach in the treatment of most paranasal sinus mucocele case in their different presentations and locations.

A Possible Association of Staphylococcus Enterotoxin B-induced Asthma and Sinusitis

In order to gain insight into a possible association between chronic sinusitis and asthma, 85 patients with sinusitis and asthma underwent functional endoscopic sinus surgical treatment and serum antibodies and cytokines were measured. The results showed that 51 out of 85 patients with high serum anti-Staphylococcus enterotoxin B （SEB） antibody before treatment obtained satisfactory results for both sinusitis and asthma. The high level of Th2 cytokine IL-4 was down regulated to the levels of normal controls after sinus surgery. Thirty-four out of 85 patients did not show high serum anti-SEB antibody before sinus surgery and did not show much improvement in their asthmatic symptoms although sinusitis symptoms were resolved by sinus surgery. It was concluded that bacterial superantigen SEB （in the sinuses） might play a crucial role in the pathogenesis of lower airway hypersensitivity.

FESS术后口服香菊胶囊联合布地奈德喷鼻治疗慢性鼻窦炎伴有鼻息肉的疗效及对患者血清IL-2、IL-6和CRP水平的影响

目的:探讨功能性内镜鼻窦手术(FESS)术后应用香菊胶囊与布地奈德联合治疗慢性鼻窦炎伴有鼻息肉(CRSwNP)的临床疗效及对患者血清白细胞介素(IL)2、IL-6和C反应蛋白(CRP)水平的影响。方法:选择2019年3月至2020年3月河北中医学院第二附属医院收治的90例行FESS治疗的CRSwNP患者,按随机数字表法平均分为对照组和观察组,每组45例。对照组患者于FESS术后采用布地奈德鼻喷雾剂喷鼻治疗,观察组患者在对照组的基础上口服香菊胶囊治疗。治疗12周后,比较两组患者的疗效及安全性;观察两组患者手术前后主观症状视觉模拟(VAS)评分、鼻内镜Lund-Kennedy评分,以及血清IL-2、IL-6和CRP水平的变化情况,并进行统计分析;比较两组患者术后1年的复发情况。结果:观察组患者的总有效率为95.6%(43/45),显著高于对照组的82.2%(37/45),差异有统计学意义(P<0.05)。两组患者术后4、8和12周的主观症状VAS评分、鼻内镜Lund-Kennedy评分均显著低于术前,且观察组患者降低更显著,差异均有统计学意义(P<0.05)。术后3 d,两组患者的血清IL-2、IL-6和CRP水平均显著高于术前(P<0.05);与术后3 d比较,两组患者术后7、15 d的血清IL-2、IL-6和CRP水平均显著降低(P<0.05);观察组患者术后3、7和15 d的血清IL-2、IL-6和CRP水平显著低于同期对照组(P<0.05),上述差异均有统计学意义。两组患者均无药品相关不良事件发生。术后1年,观察组患者的复发率较对照组显著降低[8.9%(4/45)vs.26.7%(12/45)],差异有统计学意义(P<0.05)。结论:CRSwNP患者FESS术后联合应用香菊胶囊与布地奈德治疗,疗效确切,可降低复发率,其作用机制可能与显著下调血清中IL-2、IL-6和CRP的表达水平有关。

鱼腥草滴鼻液联合鼻用糖皮质激素对真菌球型鼻窦炎FESS术后鼻腔黏膜恢复的作用

目的 观察鱼腥草滴鼻液联合鼻用糖皮质激素对真菌球型鼻窦炎(FBS)功能性鼻内镜手术(FESS)术后鼻腔黏膜恢复的作用。方法 前瞻性选取2019年5月至2022年10月仙桃市第一人民医院收治的180例FBS患者为研究对象,采用奇偶数分组法分为对照组88例和观察组92例。两组患者均给予FESS治疗,对照组术后给予鼻用糖皮质激素治疗,观察组术后在鼻用糖皮质激素基础上联合鱼腥草滴鼻液治疗。比较两组鼻黏膜整体重塑情况、鼻黏膜功能及鼻黏膜组织视野炎症细胞、EOS个数、不良反应情况的差异。评估两组视觉模拟评分法(VAS)评分、鼻腔鼻窦结局测试20(SNOT-20)评分等相关评分。结果 观察组鼻黏膜整体重塑情况优于对照组,差异有统计学意义(P>0.05)。治疗后,两组的VAS评分、SNOT-20评分、鼻内镜下LundKennedy评分(L-K)评分、鼻窦CT Lund-Mackay(L-M)评分、鼻黏膜组织视野炎症细胞、鼻黏膜组织视野EOS个数、鼻气道阻力均较治疗前下降,且观察组分别为(2.21±0.32)分、(9.15±1.96)分、(4.63±1.02)分、(6.52±0.57)分、(23.36±4.11)个、(12.77±3.02)个、(1.21±0.24) kPa·s^(-1)·L^(-1),均分别低于对照组[(3.74±0.36)分、(13.54±2.72)分、(6.29±1.28)分、(8.47±0.69)分、(27.54±5.03)个、(17.56±3.36)个、(1.72±0.36) kPa·s^(-1)·L^(-1)],差异均有统计学意义(P<0.05)。治疗后,观察组和对照组的鼻黏液纤毛清除率、鼻黏液纤毛清除速度均较治疗前升高,且观察组分别为(70.14±7.58)×10^(-2)、(6.43±0.89) mm/min,均分别高于对照组[(59.98±6.33)×10^(-2)、(5.58±0.87)mm/min],差异均有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 鱼腥草滴鼻液联合鼻用糖皮质激素可促进FBS患者FESS术后鼻黏膜功能的恢复,抑制鼻黏膜组织炎症反应,且不增加不良反应。

Oculo Orbital Complications of Sinusitis

The ocular-orbital complications of sinusitis constitute a diagnostic and therapeutic urgency that requires a correct multidisciplinary assumption. Objectives: The description of clinical and therapeutic data of the orbital complications of acute sinusitis. Methods: Our work is based on a retrospective study of 86 cases of ocular-orbital complications of sinusitis hospitalized at the ENTdepartment of Hassan II Hospital in Fes (Morocco), between the years of 2006 and 2014. Results: It is about 56 men and 30 women. The average age was 24 years, with the extremes of 3 years and 65 years. The average time of consultation was 13 dates. The achievement was frontal-ethmoido in 26 cases, and it is about a pan sinusitis in 24 cases. About 13% and 7% of cases were classified respectively in the stage III and the stage IV of chandler. The surgery was done for 24 cases. Bacteriological sample was performed among 24 patients and allowed to isolate a streptococcus (3.5%), and a staphylococcus (5.8%), and a poly microbial flora for 15.1% of patients. A death in sepsis panel was noted for a patient who presented a thrombosis of cavernous sinus. And we have noted a persistent left exophthalmia without the diminution of visual acuity for another patient. Conclusion: The orbital complications of sinusitis require a multi-disciplinary medical approach associated to ear specialist, ophthalmologist, and neuro-radiology. A precocious diagnosis, an appropriate anti-biotic therapy, and sometimes an associated surgical treatment, can significantly diminish the mortality and the morbidity related to this pathology.

Treatment of Allergic Fungal Sinusitis：a Report of 31 Cases

Objective: To evaluate the effects of different surgical procedures on allergic fungal sinusitis. Methods: Thirty-one patients with allergic fungal sinusitis under endoscopic sinus surgery(24 cases) and Caldwell-Luc operation( 7 cases) after medical treatment were investigated. Results: No complication was observed during one year's follow-up. No patient who conducted endoscopic sinus surgery reacurred and 3 patients who received traditional surgery required a second operation. Conclusion: This confirmed endoscopic sinus surgery provided a minl-traumatic and effective treatment. Combined treatment of surgical and medical ways was useful to the development of allergic fungal sinusitis.

鼻用糖皮质激素联合AmB鼻窦冲洗在真菌球型鼻窦炎FESS术后的应用研究

目的观察鼻用糖皮质激素联合两性霉素B(AmB)鼻窦冲洗在真菌球型鼻窦炎功能性鼻内镜手术(FESS)术后的应用效果。方法前瞻性选取2019年2月至2022年2月在川北医学院附属医院接受FESS治疗的94例真菌球型鼻窦炎患者为研究对象,采用信封法随机分为对照组(n=44)和观察组(n=50)。对照组术后给予鼻用糖皮质激素联合0.9%氯化钠溶液冲洗治疗,观察组术后给予鼻用糖皮质激素联合AmB鼻窦冲洗治疗。统计两组治疗2、4周后鼻腔黏膜转归情况,检测两组治疗前、治疗2、4周后的炎症因子[白细胞介素(IL)-17A、IL-6]水平,比较两组治疗前、治疗4、24周后的鼻腔纤毛传输速度、鼻窦CT评分、鼻内镜下LundKennedy评分(L-K)评分、T&T嗅觉识别测试(T&T)评分的差异,统计不良反应情况。结果治疗2、4周后,观察组鼻腔囊泡发生率分别为32.00%、18.00%,鼻腔分泌物发生率分别为20.00%和0,均低于对照组[鼻腔囊泡发生率(56.82%、43.18%)、鼻腔分泌物发生率(52.72%、63.64%)],差异均有统计学意义(P<0.05)。治疗2、4周后,观察组和对照组的IL-17A、IL-6水平均较手术前下降,且观察组IL-17A、IL-6水平均低于对照组,差异均有统计学意义(P<0.05)。治疗4、24周后,两组鼻腔纤毛传输速度均较手术前升高,且观察组均高于对照组,差异均有统计学意义(P<0.05)。治疗4、24周后,观察组和对照组的鼻窦CT评分、L-K评分、T&T评分均较治疗前下降,且观察组均低于对照组,差异均有统计学意义(P<0.05)。观察组不良反应发生率为12.00%与对照组的9.09%比较,差异无统计学意义(P>0.05)。结论鼻用糖皮质激素联合AmB鼻窦冲洗可促进真菌球型鼻窦炎FESS术后鼻腔纤毛功能的恢复,抑制炎症因子的表达,促进创面黏膜修复。

枸地氯雷他定联合鼻内镜下Messerklinger术治疗慢性鼻窦炎患者的效果

目的:观察枸地氯雷他定联合鼻内镜下Messerklinger术治疗慢性鼻窦炎(CRS)患者的效果。方法:回顾性分析2019年2月至2021年2月该院收治的94例CRS患者的临床资料,按照治疗方法不同将其分为观察组和对照组各47例。对照组行鼻内镜下Messerklinger术治疗,观察组在对照组基础上联合枸地氯雷他定治疗。比较两组临床疗效、治疗前后炎性指标[白细胞介素-1β(IL-1β)、C反应蛋白(CRP)、转化生长因子-β1(TGF-β1)]水平、鼻黏膜清除功能[黏膜纤毛清除时间(MCT)、黏膜纤毛清除速率(MCV)]、嗅觉功能Ⅰ级占比率和并发症发生率。结果:治疗后,观察组治疗总有效率为95.74%(45/47),高于对照组的80.85%(38/47),差异有统计学意义(P<0.05);观察组CRP、IL-1β、TGF-β1和MCT水平均低于对照组,差异有统计学意义(P<0.05);观察组MCV水平和嗅觉功能Ⅰ级占比率均高于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:枸地氯雷他定联合鼻内镜下Messerklinger术治疗CRS患者可提高治疗总有效率、MCV水平和嗅觉功能Ⅰ级占比率,降低炎性指标和MCT水平,效果优于单纯鼻内镜下Messerklinger术治疗。