Abstract:

Objective   To investigate the value on different evaluation indexes for nasopharyngeal carcinoma patients with post-radiotherapy chronic rhinosinusitis (post RT-CRS).  Methods   Ninty-eight  post RT-CRS patients were divided into 3 groups: the expectant treatment (group 1), the maxillary natural ostium enlargement (group 2) and the combined fenestration operation(group 3) under nasal endoscopy. Visual analogue score (VAS), sinus CT lund-mackay scores, and endoscopic lund-kennedy scores before and after treatment were analyzed.  Results   Only the VAS of purulent secretion was statistically different in group 1, but the VAS of purulent secretion and facial gas pains were statistically different in groups 2 and 3, and the curative effect of group 3 was better than that of group 2. The curative effect of maxillary sinusitis and sphenoid sinusitis were unsatisfied in group 1. The good curative effect to all sinusitis was found in the groups 2 and 3, and the curative effect of group 3 was better than group 2. The sinus CT lund-mackay scores and the endoscopic lund-kennedy scores before and after treatment had no statistical difference in group 1. The statistical difference of the lund-mackay scores could been found between groups 2 and 3 before and after treatment, post-treatment in groups 2 and 3, between the expectant group and the operation groups. The endoscopic lund-kennedy scores had no statistical difference in all groups. Conclusion   ① Maxillary natural ostium enlargement in combination with  fenestration operation under nasal endoscopy is better for post RT-CRS patients with high VAS of  purulent secretion and facial gas pains. ② As to evaluation of the extent of disease before treatment and the operation effect, sinus CT lund-mackay scores is better than  other evaluation indexes.

Key words: Chronic rhinosinusitis, Treatment plan, Evaluation index, Radiotherapy