[Effect of allergy on outcomes after endoscopic sinus surgery in patients with chronic rhinosinusitis].
OBJECTIVE
To explore correlation of allergy and outcomes after endoscopic sinus surgery (ESS) in patients with chronic rhinosinusitis.


METHODS
Before ESS, 115 cases were arranged to detect allergic serum relative index: the concentration of serum TIgE, specific IgE semi-quantitative test and the concentration of serum ECP; to survey QOL status: VAS, SNOT-20 and SF-36; as well as inquire medical record, Lund-Mackay CT system scoring, clinical classification of chronic rhinosinusitis. After ESS (>1 year), 74 cases were followed up. The subjective and objective assessment were achieved by means of VAS, SNOT-20, SF-36 and Lund-Kennedy endoscopic scores.


RESULTS
The improvements of VAS scores of the cases with increased serum TIgE were significantly lower than those without increased serum TIgE (P<0.05). In cases of II, III types, the objective outcomes of the cases with increased serum TIgE were significantly worse than those without increased serum TIgE (P<0.05). The objective outcomes of the cases with positive allergen (> or = 3) were significantly worse than those with positive allergen (<3) (P<0.05). The objective outcomes of the cases with strong positive allergen were significantly worse than those without strong positive allergen (P<0.05). VAS scores and SNOT-20 scores after endoscopic sinus surgery of the cases with strong positive allergen were significantly worse than those without strong positive allergen (P<0.05). The concentration of serum ECP of the invalid cases was significantly higher than effective cases (P<0.05). The concentration of serum ECP was positive correlated with Lund-Kennedy endoscopic scores (r=0.49, P<0.05). In cases of II, III types, the objective outcomes of the cases with increased serum ECP were significantly worse than those without increased serum ECP (P<0.05), VAS scores and SNOT-20 scores after endoscopic sinus surgery of the cases with increased serum ECP were significantly worse than those without incre- ased serum ECP (P<0.05), the improvements of VAS scores of the cases with increased serum ECP were significantly lower than those without increased serum ECP (P<0.05).


CONCLUSIONS
Those allergic serum relative indexes make some negative effect on subjective and objective outcomes. Especially, in cases with polyps, the increase of serum TIgE and serum ECP has more negative effect. Our results might help to choose immunotherapy to combine with endoscopic sinus surgery for those selected patients to improve the outcomes of chronic rhinosinusitis.
Shangguan
Chengfang
C
Department of Otolaryngology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200025, China.
Wang
Shili
S
Cai
Changping
C
Hu
Yunyun
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D000485:Allergens / Q000097:blood*; D027682:Cation Transport Proteins / Q000097:blood; D002908:Chronic Disease; D004724:Endoscopy; D047150:Eosinophil Cationic Protein / Q000097:blood*; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D008875:Middle Aged; D011184:Postoperative Period; D011788:Quality of Life; D012852:Sinusitis / Q000097:blood* / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult
D000485:Allergens; D027682:Cation Transport Proteins; D007073:Immunoglobulin E; D047150:Eosinophil Cationic Protein