Effect Of Different Ethmoid Cell Resection Degree And Sinonasal Computed Tomography Score On Postoperative Recurrence Of Chronic Rhinosinusitis With Nasal Polyps

Objective:Study of the effect of different degrees of ethmoid cells resection and sinonasal CT scores on the recurrence of chronic rhinosinusitis with nasal polyps(CRSwNP)after surgeryMethods:Forty-nine patients with CRSwNP who underwent nasal endoscopy at the Department of Otolaryngology,First Affiliated Hospital of Dali University from August 2018 to August 2020 were retrospectively collected.The age of patients ranged from 14 to 69 years(average 42 years).The collected data included the general condition of the patients,Preoperative and postoperative sinonasal CT scores,peripheral blood parameters,histological parameters,and postoperative recurrence rate after 2 years.The group of this study is based on the degree of ethmoid cells openness according to the sinonasal CT scan after surgery.Group A:the anterior ethmoid cells was completely opened;Group B:the anterior ethmoid cells was completely opened and posterior ethmoidal cells was partially opened;Group C:The ethmoid cells was completely opened.The related factors of postoperative recurrence were analyzed,and R4.1.2 was used for statistical analysis and visualization.P<0.05 indicate the difference was statistically significant.Result:1.Basic characteristics and postoperative recurrence:The recurrence rate of CRSwNP after 2 years is 55.1%.Allergic rhinitis,asthma,eosinophilic pathological results,total LM score of preoperative and postoperative sinonasal CT in the recurrent group is higher than that in the non-recurrent group,and the difference in total LM scores before and after surgery was lower in the recurrence group than in the non-recurrence group.With the increase of the resection degree of ethmoid cells,the postoperative recurrence rate decreases.The above results have statistical significance between the recurrent group and the non-recurrent group(P<0.05).2.Sinonasa CT score and postoperative recurrence:Preoperative LM(Lund-Mackay)score,sphenoid sinus score,posterior ethmoid sinus score,total ethmoid sinus score,E/M value(total ethmoid sinus score/maxillary sinus score),postoperative LM score,frontal sinus score,anterior ethmoid sinus score,posterior ethmoid sinus score,total ethmoid sinus score,sphenoid sinus score,E/M value,total score of RECs(residual ethmoid cells scoring)and anterior ethmoid sinus RECs in the recurrent group were higher than those in the non-recurrent group;The difference in total LM score before and after surgery,frontal sinus score difference,anterior septal score difference,and ethmoid sinus total score difference were lower in the recurrence group than in the non-recurrence group,and the difference in these results was statistically significant(P<0.05).3.The resection degree of ethmoid cells and sinonasal CT score:With the increase of the opening degree of ethmoid cells,LM score,anterior ethmoid score,total REC score and posterior ethmoid score decreased after operation.While the difference in total LM score before and after surgery,total ethmoid sinus score difference,anterior ethmoid score difference,posterior ethmoid score difference,and sphenoid sinus score difference increased,the above results showed statistically significant differences in different ethmoid sinus opening degree groupings(P<0.05).Conclusion:1.Increasing the resection degree of ethmoid cells during operation can improve the total LM score and anterior ethmoid score after operation.Thorough opening of ethmoid sinus during operation can reduce the postoperative recurrence rate in CRSwNP patients;2.In the sinonasal CT score,the total preoperative and postoperative LM score,ethmoid sinus score,the posterior ethmoid sinus score,sphenoid sinus score,and the E/M value were positively correlated with the risk of postoperative recurrence.The postoperative improvement value of the total LM score and the total ethmoid sinus score after surgery was negatively correlated with the recurrence risk.The increase of the total RECs score and the anterior ethmoid sinus RECs in the postoperative CT scan would increased the risk of postoperative recurrence;3.Allergic rhinitis,asthma and eosinophilic tissue were associated with CRSwNP postoperative recurrence.