A Systematic Review Of The Treatment Of Chronic Rhinosinusitis By Endoscopic Sinus Surgery Combined With Middle Turbinectomy

Objective:To evaluate the clinical outcomes of endoscopic sinus surgery combined with middle turbinectomy for chronic rhinosinusitis.Methods:To retrieve PubMed,Cochrane,OVID,EMBASE,Web of Science,CNKI,Wanfang digital journals,Vip technology journal,Chinese biomedical database(CBM),etc.Included in the randomized controlled trials,case-control study and prospective cohort study,which is about the comparison of functional nasal endoscopic sinus surgery combined with nasal turbinectomy and simple functional nasal endoscopic sinus surgery to treating chronic sinusitis.Strict literature inclusion criteria and screening criteria are formulated.According to the different research types,we evaluate the quality of a randomized controlled study by cochrane bias risk evaluation standard,and of case-control studies and cohort studies by the Newcastle-Ottawa Scale bias risk evaluation criteria.The data related to the purpose of the study were extracted from the inclusion literature,and the meta-analysis or systematic review is performed.Results:Nine literatures were included based on the inclusion and exclusion criteria,and there were 2,256 patients included,all of which had control cases.Combined with these available data,the olfactory improvement in the MTR group was more obvious than that in the MTP group(p=0.045,p= 0.0006).There was no significant difference in quality of life(p> 0.05).The results of meta-analysis of the postoperative frontal sinusitis showed that there was no statistical difference in two groups(OR 1.18[0.07,20.90],p= 0.91).The comperation of endoscopic score had no definite results.Meta-analysis show that the incidence of nasal adhesion was significantly lower in the middle turbinate group,and there were statistically significant differences between the two groups(OR 0.30[0.11,0.82],p= 0.02).Conclusion:Studies have shown that compared the MTR group to the MTP group the results of olfactory and postoperative nasal adhesion rate were better,and there was no significant difference in other outcomes.Therefore,in the treatment of CRS by FESS,it is possible to benefit more from the proper operation of the middle turbinectomy.Due to the limitation of the quality of the literature,more rigorous clinical studies are needed.