Am J Otolaryngol:CT和内窥镜在评估转诊鼻内冷冻消融术患者中的作用

2021-03-20 AlexYang MedSci原创

鼻后神经的冷冻消融(CA)作为一种基于办公室的慢性鼻炎(CR)治疗方法,已经引起了越来越多的关注。标准化的术前评估,特别是计算机断层扫描(CT)和鼻内窥镜的作用还尚未确定。

鼻后神经的冷冻消融(CA)作为一种基于办公室的慢性鼻炎(CR)治疗方法,已经引起了越来越多的关注。标准化的术前评估,特别是计算机断层扫描(CT)和鼻内窥镜的作用还尚未确定

最近,有研究人员报告了一系列接受CT和内镜检查的患者,作为转诊CA患者CR病情诊断检查的一部分。研究的目的是强调鼻内窥镜和CT扫描在CR评估中的重要性,因为存在明显的症状重叠,而且相关的鼻窦症状也很常见。

研究人员对参与的所有患者进行了回顾性分析。15名患者由医学过敏症专家送去做CA。5名患者被认为是CA候选者,1名患者仅接受了药物CR治疗。4名患者有证据表明之前的鼻窦手术未完成和/或内窥镜检查有持续的慢性鼻窦炎。该4名患者接受了药物和手术相结合的治疗,CR症状完全消失或改善。有3名患者中,CT确诊了内镜检查不明显的慢性鼻窦炎,在接受了药物和手术的联合治疗后症状有所改善。最后2名患者最终诊断为鼻瓣膜塌陷和复发性急性鼻窦炎。

该患者中,鼻内窥镜检查正常,而CT扫描能够确认筛窦和上颌窦的炎症情况

最后,研究人员指出,转诊CA越来越常见,而最优的术前检查仍不明确。在这个有限的回顾性审查中,67%的患者诊断为CR以外的疾病,因此不被认为是CA的候选者。CT和内镜检查都是对详细病史和体检的补充,可以协助选择CA候选者

原始出处:

Isaac L Schmale , William C Yao , Amber U Luong et al. The role of CT and endoscopy in the evaluation of patients referred for intranasal Cryoablation. Am J Otolaryngol. Feb 2021

 

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    2021-06-29 kalseyzl
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