Objectives:Resection of the middle turbinate(MT)during endoscopic sinus surgery(ESS)has been a controversial topic among otolaryngologists for many years.Some studies advocate resection and have shown improved outcome...Objectives:Resection of the middle turbinate(MT)during endoscopic sinus surgery(ESS)has been a controversial topic among otolaryngologists for many years.Some studies advocate resection and have shown improved outcomes postoperatively,while studies favoring preservation show a decreased incidence of postoperative complications.The current practice pattern regarding this subject is unknown.The goal of this study was to learn the current practice of MT resection during ESS among otolaryngologists.Method:We performed an electronic anonymous survey of practicing otolaryngologists.Results:We found that the majority of the 252 responders stated that they will perform an MT resection in certain clinical situations,while there is a small subset that advocates never resecting the MT for inflammatory sinus disease(n=6,2.4%).Participants were significantly more likely to perform MT resection in patients undergoing revision compared to primary ESS for all conditions included.The complication of greatest concern among participants was iatrogenic frontal sinus obstruction,while empty nose was of the least concern.The majority of participants responded that MT resection was of extreme or moderate benefit for improved visualization and drug delivery postoperatively.When compared to general otolaryngologists,fellowship-trained rhinologists were less concerned about potential complications following MT resection and were more likely to perceive an extreme or moderate benefit from turbinate resection postoperatively.Conclusion:There remains debate over MT resection among otolaryngologists,but the results of this study show that the majority of participating otolaryngologists will perform a resection in certain clinical situations.展开更多
BACKGROUND Cases of turbinate mucocele or pyogenic mucocele are extremely rare.During nasal endoscopy,turbinate hypertrophy can be detected in patients with turbinate or pyogenic mucocele.However,in many instances,dif...BACKGROUND Cases of turbinate mucocele or pyogenic mucocele are extremely rare.During nasal endoscopy,turbinate hypertrophy can be detected in patients with turbinate or pyogenic mucocele.However,in many instances,differentiating between turbinate hypertrophy and turbinate mucocele is difficult.Radiological examinations,such as computed tomography(CT)or magnetic resonance imaging(MRI),are essential for the accurate diagnosis of turbinate mucocele.Herein,we report three cases of mucocele or pyogenic mucocele of turbinate,including their clinical presentation,imaging findings,and treatments,to help rhinologists understand this condition better.CASE SUMMARY Three cases of turbinate and pyogenic mucocele were encountered in our hospital.In all patients,nasal obstruction and headache were the most common symptoms,and physical examination revealed hypertrophic turbinates.On CT scan,mucocele appeared as non-enhancing,homogeneous,hypodense,well-defined,rounded,and expansile lesions.Meanwhile,MRI clearly illustrated the cystic nature of the lesion on T2 sequences.Two patients with inferior turbinate mucocele underwent mucocele lining removal,while the patient with pyogenic mucocele underwent endoscopic middle turbinate marsupialization.The patients were followed up on the first,third,sixth month,and 1 year after discharge,and no complaints of headache and nasal congestion were reported during this period.CONCLUSION In conclusion,both CT and MRI are helpful in the diagnosis of turbinate or pyogenic mucocele.Additionally,endoscopic nasal surgery is considered to be the most effective treatment method.展开更多
目的研究轮廓化鼻内镜手术(radical sinus su rger y,R SS)治疗难治性慢性鼻-鼻窦炎(CR S)的临床疗效。方法 49例伴支气管哮喘的难治性CRS患者,被随机分为功能性鼻内镜手术(functionalendoscopic sinussurgery,FESS)组和RSS组。在治疗...目的研究轮廓化鼻内镜手术(radical sinus su rger y,R SS)治疗难治性慢性鼻-鼻窦炎(CR S)的临床疗效。方法 49例伴支气管哮喘的难治性CRS患者,被随机分为功能性鼻内镜手术(functionalendoscopic sinussurgery,FESS)组和RSS组。在治疗前、后评估鼻部症状、鼻内镜Lund-Kennedy评分和生活质量评分等。结果术后1~3年,RSS组流脓涕及嗅觉下降症状评分的改善均优于FESS组(2.60±1.0 vs 3.88±0.85,t=4.799,P<0.001;2.80±1.16 vs 4.58±1.95,t=3.908,P<0.001)。R S S组鼻内镜Lund-Kennedy评分明显优于FESS组(6.44±1.23 vs 7.29±1.00,t=2.657,P=0.011)。在生活质量改善方面,RSS组也显著优于FESS组(21.36±4.87 vs28.17±6.82,t=4.033,P<0.001)。结论对于伴哮喘的难治性CRS患者,RSS的根治性术式相比单纯FESS可以更好的改善术后症状、内镜评分及生存质量,值得临床应用。展开更多
文摘Objectives:Resection of the middle turbinate(MT)during endoscopic sinus surgery(ESS)has been a controversial topic among otolaryngologists for many years.Some studies advocate resection and have shown improved outcomes postoperatively,while studies favoring preservation show a decreased incidence of postoperative complications.The current practice pattern regarding this subject is unknown.The goal of this study was to learn the current practice of MT resection during ESS among otolaryngologists.Method:We performed an electronic anonymous survey of practicing otolaryngologists.Results:We found that the majority of the 252 responders stated that they will perform an MT resection in certain clinical situations,while there is a small subset that advocates never resecting the MT for inflammatory sinus disease(n=6,2.4%).Participants were significantly more likely to perform MT resection in patients undergoing revision compared to primary ESS for all conditions included.The complication of greatest concern among participants was iatrogenic frontal sinus obstruction,while empty nose was of the least concern.The majority of participants responded that MT resection was of extreme or moderate benefit for improved visualization and drug delivery postoperatively.When compared to general otolaryngologists,fellowship-trained rhinologists were less concerned about potential complications following MT resection and were more likely to perceive an extreme or moderate benefit from turbinate resection postoperatively.Conclusion:There remains debate over MT resection among otolaryngologists,but the results of this study show that the majority of participating otolaryngologists will perform a resection in certain clinical situations.
文摘BACKGROUND Cases of turbinate mucocele or pyogenic mucocele are extremely rare.During nasal endoscopy,turbinate hypertrophy can be detected in patients with turbinate or pyogenic mucocele.However,in many instances,differentiating between turbinate hypertrophy and turbinate mucocele is difficult.Radiological examinations,such as computed tomography(CT)or magnetic resonance imaging(MRI),are essential for the accurate diagnosis of turbinate mucocele.Herein,we report three cases of mucocele or pyogenic mucocele of turbinate,including their clinical presentation,imaging findings,and treatments,to help rhinologists understand this condition better.CASE SUMMARY Three cases of turbinate and pyogenic mucocele were encountered in our hospital.In all patients,nasal obstruction and headache were the most common symptoms,and physical examination revealed hypertrophic turbinates.On CT scan,mucocele appeared as non-enhancing,homogeneous,hypodense,well-defined,rounded,and expansile lesions.Meanwhile,MRI clearly illustrated the cystic nature of the lesion on T2 sequences.Two patients with inferior turbinate mucocele underwent mucocele lining removal,while the patient with pyogenic mucocele underwent endoscopic middle turbinate marsupialization.The patients were followed up on the first,third,sixth month,and 1 year after discharge,and no complaints of headache and nasal congestion were reported during this period.CONCLUSION In conclusion,both CT and MRI are helpful in the diagnosis of turbinate or pyogenic mucocele.Additionally,endoscopic nasal surgery is considered to be the most effective treatment method.
文摘目的研究轮廓化鼻内镜手术(radical sinus su rger y,R SS)治疗难治性慢性鼻-鼻窦炎(CR S)的临床疗效。方法 49例伴支气管哮喘的难治性CRS患者,被随机分为功能性鼻内镜手术(functionalendoscopic sinussurgery,FESS)组和RSS组。在治疗前、后评估鼻部症状、鼻内镜Lund-Kennedy评分和生活质量评分等。结果术后1~3年,RSS组流脓涕及嗅觉下降症状评分的改善均优于FESS组(2.60±1.0 vs 3.88±0.85,t=4.799,P<0.001;2.80±1.16 vs 4.58±1.95,t=3.908,P<0.001)。R S S组鼻内镜Lund-Kennedy评分明显优于FESS组(6.44±1.23 vs 7.29±1.00,t=2.657,P=0.011)。在生活质量改善方面,RSS组也显著优于FESS组(21.36±4.87 vs28.17±6.82,t=4.033,P<0.001)。结论对于伴哮喘的难治性CRS患者,RSS的根治性术式相比单纯FESS可以更好的改善术后症状、内镜评分及生存质量,值得临床应用。
