| ObjectiveTo retrospectively analyze the clinical case data of 207 patients with chronic sinusitis and nasal polyps in Qilu Hospital of Shandong University,combined with the results of the follow-up visit,describe the characteristics of the cases and group them according to the degree of disease control,using statistical analysis to explore the related risk factors of disease control among the different groups.The purpose of this study is to provide data support for the diagnosis,treatment and prognosis of chronic sinusitis with nasal polyps disease.MethodsCollecting the clinical data of patients with chronic sinusitis and nasal polyps who were treated by surgery in the Department of Otorhinolaryngology Head and Neck Surgery,Qilu Hospital of Shandong University from January 2016 to January 2019,establish a database,describe the characteristics of the cases based on the results of the return visit,and group them for disease control.Analyzing data with SPSS 22.0 statistical software,using Kruskal-Wallis test to compare differences between different groups.The factors with statistical difference were further compared by Mann-Whitney U test,using Spearman correlation coefficient to detect the correlation,using ROC curve with established risk prediction model to predict prognosis.Take P<0.05 as the difference is statistically significant.Results1.In this study,a total of 231 patients with chronic sinusitis with nasal polyps were collected.After excluding patients who were lost to follow-up,complete follow-up data of 207 patients were finally obtained,including 141 males(68.1%)and 66 females(31.9%).The ratio of male to female is shown in Figure 1.The age is between 13-80 years old,with an average of(43.9115.3)years old.There were 46 patients with allergic rhinitis,35 patients with asthma,24 patients with allergic rhinitis and asthma,56 patients with underlying diseases(hypertension and/or diabetes),and 44 patients with nasal septum deviation.2.As of the follow-up time(December 20,2020),the follow-up time was 22-58 months.According to the follow-up results,they were divided into the complete controlled group with 146 cases,the partial controlled group with 47 cases,uncontrolled group with 14 cases.Among the 146 patients in the complete control group,120 were first-onset and 26 were relapsed.35 were first-onset and 12 were relapsed with 47 patients in the partial-control group.And in the uncontrolled group,half were first-onset and another half were relapsed.3.The analysis of three groups showed that with allergic rhinitis and/or asthma,nasal septum deviation,preoperative CT nasal sinus scores,OMC scores and peripheral blood eosinophil counts and ratios were Statistically different.Further comparison of differences between any two groups showed that there were significant differences between allergic rhinitis and/or asthma,nasal septum deviation,and blood eosinophil count between complete controlled and partial-controlled groups,complete controlled and uncontrolled groups4.Differences in postoperative symptom scores between the partially controlled and uncontrolled groups were compared,and the results showed that olfactory disturbances were not significantly improved in the two groups.5.Among the 207 patients,there were 118 patients with olfactory dysfunction before surgery.According to the follow-up results,50 patients had recovered and 68 patients still have olfactory disorders.The statistical results showed that there is a statistical difference in smoking,allergic rhinitis and/or asthma,intraoperative removal of the middle turbinate,peripheral blood eosinophil count and ratio,OMC score and E/M value between the two groups.6.The olfactory recovery risk model composed of blood eosinophil ratio and count,OMC score,and E/M had an AUC of 0.799,P<0.001.Conclusion1.Combined with allergic rhinitis and/or asthma,with nasal septum deviation,peripheral blood eosinophil count and ratio,preoperative CT score of each group of sinus scores and OMC scores were the risk factors which affect the disease control of patients with chronic sinusitis and nasal polyps.2.Nasal obstruction,hypersecretion,and Olfactory disorders are all clinical symptoms that most bother patients before surgery.Among them,olfactory disorders is the most difficult symptom to recover in part of the control group and the uncontrolled group.3.Smoking,allergic rhinitis and/or asthma,intraoperative removal of the middle turbinate,peripheral blood eosinophil count and ratio,OMC score and E/M value are all factors that affect the recovery of the olfaction,in which allergic rhinitis,asthma and E/M is especially risk factors.4.The preoperative olfactory VAS score has a certain correlation with peripheral blood eosinophil count and ratio,and E/M value.The full model composed of blood routine eosinophil count and ratio,OMC score,E/M has certain guiding significance for the prediction of olfactory recovery. |
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