| background and objective Chronic rhinosinusitis and nasal polyps are very common in otorhinolaryngology.Some patients with chronic rhinosinusitis do not have nasal polyps,while most patients usually have nasal polyps.In patients with chronic rhinosinusitis,the presence and stimulation of long-term chronic inflammation make nasal mucosa edema,and over time,nasal polyps are accompanied.The edema of nasal mucosa and the existence of nasal polyps make the nasal cavity blocked,and the existence of olfactory depends on the patency of nasal cavity,especially the nasal cavity of olfactory area.Therefore,for patients with chronic rhinosinusitis accompanied by nasal polyps,olfactory loss is very common,even the main symptoms,which seriously affect the quality of life of patients.Endoscopic sinus surgery is currently widely used in the treatment of chronic rhinosinusitis with nasal polyps.Its drainage effect is clear and the effect of removing nasal obstruction is good,which is highly praised in clinical practice.However,whether endoscopic surgery can improve the olfactory sense of patients is still controversial.Therefore,this study is based on the chronic rhinosinusitis with nasal polyps Objective To observe the changes of olfactory function in patients with chronic rhinosinusitis and nasal polyps before and after endoscopic sinus surgery.Materials and Methods Patients with chronic rhinosinusitis admitted to our hospital from January 2018 to January 2019 were selected.All patients were complicated with nasal polyps and olfactory disturbance,and a total of 120 patients were included.The patients underwent CT examination(coronal and axial),Lund Mackay score on CT,VAS score and T & T test of olfactory before operation.All patients were treated with endoscopic sinus surgery after exclusion of contraindications.VAS score of olfactory visual analogue scale and T & T test of olfaction were performed again at 1 month,3 months and 6 months after operation.Objective to analyze the correlation between VAS score of olfactory visual analogue scale(VAS),T & T test of olfactory and Lund Mackay score of nasal CT,and compare the changes and differences of preoperative and postoperative scores at different time points.Results(1)The VAS score of olfactory visual analogue scale at different time points showed that: compared with preoperative,85.83% of patients had improved olfaction at 6 months after operation;at 1 month after operation,the VAS score of patients had statistical difference compared with that before operation;at 3 months after operation,VAS score of patients had statistical difference compared with that before operation and 1 month after operation;at 6months after operation,the VAS score of patients had statistical difference The VAS score of the patients had statistical difference compared with that before operation and 1 month after operation,but there was no significant difference compared with 3 months.(2)The T & T test of olfactory at different time points showed that: compared with preoperative,85.83% of patients’ olfactory improved 6 months after operation;1 month after operation,the T& T test score of patients had statistical difference compared with that before operation;3months after operation,the T & T test score of patients had statistical difference compared with that before operation and 1 month after operation;at 6 months after operation,the T & T test score of patients had statistical difference &The t test score was statistically different from that before operation and 1 month after operation,but there was no significant difference compared with 3 months.(3)Correlation analysis showed that there was a negative correlation between Lund Mackay score of preoperative sinus CT and VAS score and T & T test score at 6 months after operation,that is,the lower Lund Mackay score of preoperative sinus CT,the better the improvement of VAS score and T & T test score at 6 months after operation.Conclusion(1)Patients with chronic rhinosinusitis with nasal polyps received minimally invasive nasal endoscopic surgery,the overall improvement effect of olfactic function was significant,and the benign outcome rate could reach 85.83%,which would effectively improve the overall quality of life of patients.(2)The peak time node of olfactoric function after minimally invasive surgery of CRSWNP nasal endoscope was 3 months after surgery,with VAS score(2.0±0.5)and T&T score(2.1±1.1)at 3 months after surgery.VAS score(1.5±0.5)and T&T score(2.0±0.8)6 months after surgery.There was no statistically significant difference between 3 and 6 months after surgery.(3)The overall effect of minimally invasive nasal endoscopic surgery with CRSWNP was significant,but it could not improve the olfactory function of all patients after surgery.For patients with CRSWNP with a disease course longer than 10 years,the Lund-Mackay CT score is greater than grade 4,and the preoperative efficacy is not accurate for patients with severe olmia.There are even some cases of further deterioration of olfactory function after surgery,the reasons may be many.This is an important event to watch.(4)The results showed that the higher the preoperative sinus CT score of CRSWNP patients,the worse the postoperative olfactory improvement effect of patients.It also suggested that sinus CT examination had a good correlation with subjective symptom VAS score,and had a certain prospect for postoperative prognosis evaluation. |
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