Halil Erdem ÖZEL, Serpil ARIKAN, Özer Erdem GÜR, Cafer ÖZDEM

Objective and subjective eff ects of surgical treatment of nasal obstructions in patients with asthma

Amaç: Üst ve alt solunum yolları hastalıkları arasında bir ilişki olduğuna dair birçok kanıt mevcuttur. Bu çalışmanın amacı, nazal obstrüksiyona yol açan patolojilerin cerrahi tedavisinin astım üzerine objektif ve subjektif etkilerini incelemektir. Yöntem ve gereç: Bu çalışmada astımı olan 17 olgu iki gruba bölünmüştür. Septum ve/veya konka hastalıklarına sahip 9 hasta grup 1’i oluşturmuştur. Nazal polipozis veya beraberinde septum deviyasyonuna da sahip 8 hasta grup 2’yi oluşturmuştur. Tüm hastaların nazal endoskopik muayeneleri yapılmıştır ve paranazal sinüs bilgisayarlı tomografi leri çekilmiştir. Sistemik steroid tedavisinden fayda görmeyen nazal polipozis olguları çalışmaya dahil edilmiştir. Tüm hastaların nazal obstrüksiyonları cerrahi olarak tedavi edilmiştir. Hastalar preoperatif olarak ve postoperatif üçüncü ayda sinonazal semptomları yönünden sorgulanmıştır, astım şiddeti belirlenmiştir ve solunum fonksiyon testleri yapılmıştır. Bulgular: Her iki grupta da postoperatif FEV1 (birinci saniyesindeki zorlu ekspiratuvar hacim) ve FEF 25-75 (zorlu ekspirasyon ortasındaki akım hızı) ortalama değerlerinde düzelme olmasına rağmen istatiksel olarak anlamlıbulunmamıştır (P > 0,05). Tüm hastaların astım şiddetinde ve yaklaşık yarısında astım nedeniyle kullandığı ilaç dozlarında azalma olmuştur. Her iki grupta da burun tıkanıklığı, baş ağrısı ve postnazal akıntı en sık rastlanan semptomlardır. Cerrahi tedavi sonrası bu semptomlarda belirgin iyileşme sağlanmıştır. Sonuç: Nazal obstrüksiyonların cerrahi tedavisi ile sinonazal semptomlar ve astım şiddeti azalmaktadır. Bu etkiler hastaların yaşam kalitesini belirgin olarak arttırmaktadır.

Astımı olan hastalarda nazal obstrüksiyonların cerrahi tedavisinin objektif ve subjektif etkileri

Aim: Th ere is a lot of evidence indicating an association between upper and lower airway diseases. Th e objective of this study was to investigate the objective and subjective eff ects of surgical treatment of pathologies causing nasal obstruction in relation with asthma. Materials and methods: In this study, 17 patients with asthma were divided into 2 groups. Nine patients with septal and/or disorders of turbinate constituted group 1, and 8 patients with nasal polyposis or concomitant septal deviation constituted group 2. Nasal endoscopic examination was performed and paranasal sinus computed tomography was obtained for each patient. Subjects with nasal polyposis, refractory to systemic steroid treatment, were included in the study. Nasal obstruction was treated surgically in all patients. Preoperatively and 3 months postoperatively patients were evaluated in terms of sinonasal symptoms, severity of asthma, and pulmonary function tests. Results: Th e mean FEV1 (forced expiratory volume in the fi rst second) and FEF25-75 (forced midexpiratory fl ow rate) rates were improved in both groups postoperatively, but this diff erence was not statistically signifi cant (P > 0.05). Severity of asthma and dosage of asthma medications were reduced in all patients and in half of the patients, respectively. Nasal obstruction, headache, and postnasal drip were the most frequent symptoms in both groups. Th ese symptoms improved markedly aft er the surgery. Conclusion: Sinonasal symptoms and severity of asthma reduce with the surgical treatment of nasal obstructions, which increase the quality of life of patients signifi cantly.

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