| Background:Chronic sinusitis belongs to multiple inflammatory lesions of the nose in otorhinolaryngology head and neck surgery.As a common complication of chronic sinusitis,nasal polyp will aggravate the condition and clinical treatment to a certain extent.When drug therapy fails,endoscopic sinus surgery（ESS）is the first choice.It has been proposed that the removal of the middle turbinate during ESS can improve the prognosis of patients with chronic sinusitis and nasal polyps.However,the removal of the middle turbinate and its efficacy remain controversial in clinical practice.The purpose of this study was to investigate the effect of middle turbinate resection during endoscopic sinus surgery on postoperative efficacy and nasal function of patients with chronic sinusitis and nasal polyp.Methods:Select the first hospital affiliated to China university of science and technology（hospitals）in anhui province from September 2019 to September 2020 were moderately severe bilateral symmetry of 40 cases of patients with chronic sinusitis and nasal polyp and all patients following randomization,side removal of the middle turbinate in endoscopic sinus surgery,nasal cavity side nasal cavity reserved middle turbinate in endoscopic sinus surgery,Each participant controls for himself.Preoperative analysis of the resection and retention sides of patients with chronic sinusitis with nasal polyps was performed using sinus CT（Lund-Mackay）score.Nasal endoscopy（Lund-Kennedy）score,nasal resistance（NR）and nasal acoustic reflex（NCV）,quality of life（SNOT-22）score,visual analogue scale（VAS）score and Sniffin score were usedA comparison was made between the resection side and the retention side of patients with chronic sinusitis and nasal polyp before,6 months after,and 12 months after surgery.Results:① Preoperative nasal sinus CT Lund-Mackay score showed no statistically significant difference between the resected side and the reserved side,and between the resected side and the reserved side（9.8 ± 2.2＆9.8 ± 2.1）（P>0.05）.②There was no significant difference in preoperative lund-Kennedy scores between the resected and reserved nasal passages（5.15 ± 1.79＆5.23 ± 1.64,P=0.98）.The lund-Kennedy score on the resected side was lower than that on the reserved side（2.65± 1.32＆3.71 ± 1.78）,and 12 months after surgery,the lund-Kennedy score on the resected side was lower than that on the reserved side（1.58 ± 0.56＆2.88 ± 0.91）.The overall difference was statistically significant（F=4.090,P=0.0179）;③There was no statistically significant difference between the Sniffin Sticks test scores of the resection side and the preserved side before surgery（13.14 ± 1.12＆13.21 ± 1.13,P=0.99）.The Sniffin Sticks test scores on the resected side were higher than those on the retained side（19.13 ± 1.39＆17.86 ± 1.42）.The Sniffin Sticks test score of the excised side was higher than that of the reserved side（21.23 ± 1.53＆19.34 ± 1.49）,and the difference was statistically significant（F=10.91,P=0.000）;④ There was no statistically significant difference in nasal resistance between the resected side and the reserved side before surgery（1.50 ± 0.26＆1.49 ± 0.29）（P=0.99）.Six months after surgery,the nasal resistance on the resected side was lower than that on the reserved side（0.62 ± 0.23＆0.84 ± 0.21）.Compared with the reserved side,the nasal resistance of the resected side was lower（0.36 ± 0.11＆0.55 ± 0.08）,and the difference was statistically significant（F=7.021,P=0.001）.There was no significant difference in NCV between the excised and reserved nasal passages（4.35±0.52＆4.41± 0.49）before surgery（P=0.97）.Six months after surgery,NCV of the excised nasal passages was higher than that of the reserved nasal passages（7.32 ± 0.84＆6.41 ±0.73）.Twelve months after surgery,the NCV of the resected nasal cavity was higher than that of the reserved one（8.26 ± 0.78＆7.45 ± 0.88）,the difference was statistically significant（F=4.504,P=0.000）;⑤There was no significant difference in nasal obstruction（8.34 ± 0.45＆8.45 ± 0.52）and runny nose score（7.45 ± 1.56＆7.32 ± 1.49）between the resection side and the reserved side before surgery（P=0.99,P=0.98）.The nasal obstruction and runny nose scores on the resected side were lower than those on the preserved side（3.52±0.65＆4.77 ± 0.65）and runny nose scores（3.47 ± 1.62＆4.24 ± 1.71）.The nasal obstruction score and runny nose score on the resected side were lower than those on the preserved side（1.28 ± 0.55＆2.51 ± 0.55）and runny nose score（1.40 ± 0.51＆2.64 ± 0.60）,and the overall difference was statistically significant（F=27.31,P=0.000;F=5.374,P=0.005）;⑥There was a statistically significant difference between preoperative SNOT22 score and postoperative 6 months（53.61 ± 16.94＆27.44 ± 11.56）（P=0.0001）.12 months after surgery,the SNOT22 score of patients’ quality of life was significantly different from that before surgery（12.27 ± 6.54＆53.61 ± 16.94）（P=0.0001）.Conclusions:The removal of middle turbinate during endoscopic sinus surgery can improve the nasal mucosa morphology,nasal ventilation and smell of patients with moderate and severe chronic sinusitis accompanied by nasal polyp,and improve the quality of life of patients,which has certain clinical application value. |
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