Association of Comorbid Asthma and the Efficacy of Bioabsorbable Steroid-eluting Sinus Stents Implanted After Endoscopic Sinus Surgery in Patients with Chronic Rhinosinusitis with Nasal Polyps  

作　　者：Ao HUANG Tao LI Min-shan LI Zhen-xiao HUANG De-hui WANG Lei CHENG Bing ZHOU Heng WANG Zheng LIU 

机构地区：[1]Department of Otolaryngology-Head and Neck Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China [2]Institute of Allergy and Clinical Immunology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China [3]Hubei Clinical Research Center for Nasal Inflammatory Diseases,Wuhan 430030,China [4]Department of Otolaryngology-Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,Beijing 100000,China [5]Department of Otolaryngology-Head and Neck Surgery,Eye,Ear,Nose and Throat Hospital,Fudan University,Shanghai 200000,China [6]Department of Otorhinolaryngology&Clinical Allergy Center,The First Affiliated Hospital,Nanjing Medical University,Nanjing 210029,China

出　　处：《Current Medical Science》2023年第5期1005-1012,共8页当代医学科学（英文）

基　　金：supported by grants from the National Natural Science Foundation of China(No.81873694);the Key Research and Development Program of Hubei Province(No.2021BCA119 and No.2022BCA005);Knowledge Innovation Program of Wuhan-Basic Research(No.2022020801010446).

摘　　要：Objective To identify factors affecting the efficacy of steroid-eluting sinus stents implanted after endoscopic sinus surgery(ESS)in patients with chronic rhinosinusitis with nasal polyps(CRSwNP).Methods We performed a post-hoc analysis of a randomized self-controlled clinical trial on post-operative implantation of bioabsorbable steroid-eluting stents in patients with CRSwNP.Univariate logistic regression analysis was conducted to identify which of the following factors affect the response to post-operative stent implantation:sex,serum eosinophil levels,history of prior surgery,endoscopic scores,and comorbid conditions(asthma and allergic rhinitis).The primary outcome was the rate of post-operative intervention on day 30,and the secondary outcome was the rate of polypoid tissue formation(grades 2–3)on days 14,30,and 90.Results A total of 151 patients with CRSwNP were included in the post-hoc analysis.Asthma was identified as the only risk factor for a poor response to steroid-eluting sinus stents on post-operative day 30,with an odds ratio of 23.71(95%CI,2.81,200.16;P=0.004)for the need for post-operative intervention and 19(95%CI,2.20,164.16;P=0.003)for moderate-to-severe polypoid tissue formation.In addition,the asthmatic group showed higher rates of post-operative intervention and polypoid tissue formation than the non-asthmatic group on post-operative day 30.Blood eosinophil levels were not identified as a risk factor for poor outcomes after stent implantation.Conclusion Comorbid asthma,but not blood eosinophil level,impairs the efficacy of steroid-eluting sinus stents in the short term after ESS in patients with CRSwNP.

关 键 词：chronic rhinosinusitis ASTHMA nasal polyps outcome steroid-eluting sinus stent 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]