Subtotal Middle Turbinate Resection in Patients with Chronic Rhinosinusitis with Nasal Polyps is Unlikely to Cause Empty Nose Syndrome: A Multi-Institutional Prospective Study.

Autor: Eide JG; Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health, Detroit, Michigan, USA., Kuan EC; Department of Otolaryngology-Head and Neck Surgery, University of California-Irvine, Irvine, CA, USA., Adappa ND; Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA., Chang J; Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA., Cho DY; Department of Otolaryngology-Head and Neck Surgery, University of Alabama, Birmingham, AL, USA., Garg R; Department of Otolaryngology-Head and Neck Surgery, Kaiser Permanente Orange County, Anaheim, CA, USA., Govindaraj S; Department of Otorhinolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Grayson J; Department of Otolaryngology-Head and Neck Surgery, Kaiser Permanente Orange County, Anaheim, CA, USA., Im E; Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health, Detroit, Michigan, USA., Keschner D; Department of Otolaryngology-Head and Neck Surgery, Kaiser Permanente Orange County, Anaheim, CA, USA., Kohanski M; Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA., Locke T; Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, TX, USA., Palmer JN; Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA., Welch KC; Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA., Woodworth BA; Department of Otolaryngology-Head and Neck Surgery, University of Alabama, Birmingham, AL, USA., Yoo F; Department of Otolaryngology-Head and Neck Surgery, Kaiser Permanente Orange County, Anaheim, CA, USA., Craig JR; Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health, Detroit, Michigan, USA.
Jazyk: angličtina
Zdroj: The Laryngoscope [Laryngoscope] 2024 Aug 13. Date of Electronic Publication: 2024 Aug 13.
DOI: 10.1002/lary.31694
Abstrakt: Background: Empty nose syndrome (ENS) is a poorly understood, debilitating condition affecting a minority of patients who underwent nasal airway surgery, most commonly following inferior turbinate surgery. Few publications have demonstrated middle turbinate resection (MTR) causing ENS, but MTR is still considered a potential cause of ENS. The Empty Nose Syndrome 6-item Questionnaire (ENS6Q) is validated for ENS diagnosis, with ENS6Q ≥ 11 considered highly suggestive of ENS. The purpose of this multicenter study was to determine the incidence of patients with ENS6Q ≥ 11 following subtotal MTR during endoscopic sinus surgery (ESS) for chronic rhinosinusitis with nasal polyps (CRSwNP) by comparing preoperative and postoperative ENS6Q scores.
Methods: A multi-institutional prospective cohort study (8 US institutions) was conducted on patients who underwent bilateral subtotal MTR during ESS for CRSwNP. Preoperative and postoperative ENS6Q scores were compared after at least 12 months of postoperative follow-up.
Results: Of 110 patients, mean age was 51.6 years and 59.1% were male. Mean follow-up was 14.5 ± 2.5 months (range 12.1-22.3 months). Mean preoperative and postoperative ENS6Q were 7.7 and 2.2, respectively, demonstrating a mean 5.5 point decrease postoperatively (p < 0.0001). At final follow-up, no patient had an ENS6Q ≥ 11. Of note, 20% of patients had preoperative ENS6Q scores ≥11, but all decreased to <11 postoperatively.
Conclusions: Based on prospective multicenter data over 1-2 years postoperatively, subtotal MTR for CRSwNP never led to ENS6Q scores ≥11, and patients experienced significant decreases in ENS6Q postoperatively. Subtotal MTR during ESS for CRSwNP was, therefore, unlikely to cause ENS even with long-term follow-up.
Level of Evidence: 4 Laryngoscope, 2024.
(© 2024 The American Laryngological, Rhinological and Otological Society, Inc.)
Databáze: MEDLINE
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