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Postoperative mometasone irrigations improve quality of life in skull base tumor patients

World Journal of Otorhinolaryngology-Head and Neck Surgery 2023年第4期9卷 314-319页

作者： Mandy K.Salmon Rijul S.Kshirsagar Jacob G.Eide Auddie M.Sweis Kathleen Davin Aman Prasad Heather Ungerer Elizabeth Stevens Kevin Ig‐Izevbekhai Siddhant Tripathi Tran B.Locke Theodore Lin Brian M.Sweis michael a.kohanski Nithin D.Adappa James N.Palmer Department of Otorhinolaryngology—Headand Neck Surgery University of PennsylvaniaPhiladelphiaPennsylvaniaUSA Division of Otolaryngology—Head and Neck Surgery North Shore University Health SystemThe University of ChicagoEvanstonIllinoisUSA University of Cincinnati School of Medicine CincinnatiOhioUSA Department of Otolaryngology Baylor College of MedicineHoustonTexasUSA Lewis Katz School of Medicine Temple UniversityPhiladelphiaPennsylvaniaUSA Department of Neuroscience University ofMinnesotaMinneapolisMinnesotaUSA

Objectives:The use of topical corticosteroids to manage postoperative sinonasal symptoms after endoscopic skull base surgery (ESBS) has not been well *** quantified long‐term impact of postoperative steroid irrigations (SIs) on quality of life of patients after ***:Retrospective review of patients at the University of Pennsylvania undergoing ESBS from 2010 to *** on patient demographics and postoperative treatment with nasal saline irrigation twice daily with and without dissolved steroids (mometasone or budesonide) was ***,and 1‐,3‐,6‐,12‐,18‐,and 24‐month postoperative Sino‐Nasal Outcome Test (SNOT‐22) scores were ***:A total of 727 patients were assessed (53.4% males),with 479 patients in the no SI group and 248 patients in the SI *** SNOT‐22 scores did not differ significantly (P = 0.19).1‐,3‐,6‐,12‐,18‐,and 24‐month post‐op SNOT‐22 scores did not significantly differ between ***,mometasone irrigations resulted in significantly lower postoperative 2‐year SNOT‐22 scores compared to budesonide (P < 0.01) and saline (P = 0.03).Conclusions:Though corticosteroid irrigations are routine in managing inflammatory sinus disease,their role in postoperative management after ESBS for tumors is *** findings suggest that mometasone irrigation may be effective at improving postoperative quality of life in patients after ESBS.

关键词： postoperative steroid irrigations skull base tumors

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The impact of endoscopic sinus surgery and aspirin desensitization on psychological burden in aspirin-exacerbated respiratory disease

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2020年第4期6卷 214-219页

作者： Tran Locke Auddie Sweis Theodore Lin Brian Sweis Patrick Gleeson michael kohanski Nithin Adappa James Palmer John Bosso Deportment of Otolarynsology Baylor College of MedicineHoustonTXUSA Division of Otolaryngology NorthShore University Health SystemEvanstonILUSA Lewis Kotz School of Medicine Temple UniversityPhiladelphiaPAUSA Department of Neuroscience University of MinnesotaMinneapolisMNUSA Department of Allersy Et Immunolosy University of PennsylvaniaPhiladelphiaPAUSA Deportment of Otorhinolaryngology University of PennsylvaniaPhiladelphiaPAUSA

Background:Aspirin-exacerbated respiratory disease(AERD)is an aggressive inflammatory disorder of the upper and lower respiratory ***,leukotriene modifiers,endoscopic sinus surgery(ESS),aspirin(ASA)desensitization,and biological immu-nomodulators are currently used to treat the ***:The objective of this study was to determine the psychosocial impact of ESS and ASA desensitization on AERD ***:All AERD patients who underwent complete ESS were divided into two cohorts based on ASA desensitization *** psychosocial metrics of the SNOT-22 were collected and analyzed at the following time points:pre-operative,1-month,3-month,6-month,and 12-month after ***:One hundred and eighty-four AERD patients underwent ESS from November 2009 to November *** this group,130 patients underwent ASA desensitization(AD cohort)and 54 patients remained non-desensitized(ND cohort).AD patients showed a significantly greater reduction in total SNOT-22 scores over the study period compared to ND patients(p=0.0446).Analysis of SNOT-22 psychosocial metrics showed a significantly greater improvement in patient productivity in the AD cohort when compared to the ND cohort(p=0.0214).Further,a sub-group analysis accounting for subject attrition showed a significantly greater improvement in both productivity and concentration in AD patients when compared to the ND cohort(productivity:p=0.0068;concentration:p=0.0428).Conclusions:ESS followed by ASA desensitization decreases the overall psychosocial burden in AERD patients with a significant improvement in perceived productivity and *** has significant implications given the psychosocial impact of chronic diseases.

关键词： Psychosocial domain AERD Aspirin desensitization Sinus surgery

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