{"id":81,"date":"2017-10-27T16:11:34","date_gmt":"2017-10-27T15:11:34","guid":{"rendered":"https:\/\/icare-cro.com\/blog\/?p=81"},"modified":"2020-01-28T16:32:49","modified_gmt":"2020-01-28T15:32:49","slug":"rinosinusite-poliposi-nasale","status":"publish","type":"post","link":"https:\/\/icare-cro.com\/blog\/2017\/10\/27\/rinosinusite-poliposi-nasale\/","title":{"rendered":"Rinosinusite cronica con poliposi nasale: quando e come operare."},"content":{"rendered":"<span class=\"span-reading-time rt-reading-time\" style=\"display: block;\"><span class=\"rt-label rt-prefix\">Reading Time: <\/span> <span class=\"rt-time\"> 2<\/span> <span class=\"rt-label rt-postfix\">minutes<\/span><\/span><h6><strong><i>La terapia medica personalizzata consente di ottenere un buon controllo della sintomatologia nei pazienti con rinosinusite cronica con polipi e basso tasso di ricorso alla chirurgia. L\u2019intervento di chirurgia endoscopica nasosinusale funzionale permette di ottenere notevoli vantaggi sulla qualit\u00e0 di vita con minimi rischi intra e post-operatori.<\/i><\/strong><\/h6>\n<figure id=\"attachment_82\" aria-describedby=\"caption-attachment-82\" style=\"width: 149px\" class=\"wp-caption alignright\"><img wpfc-lazyload-disable=\"true\" loading=\"lazy\" decoding=\"async\" class=\"wp-image-82\" src=\"https:\/\/icare-cro.com\/blog\/wp-content\/uploads\/2017\/10\/CORONALE-frontal-300x210.jpg\" alt=\"\" width=\"149\" height=\"104\" srcset=\"https:\/\/icare-cro.com\/blog\/wp-content\/uploads\/2017\/10\/CORONALE-frontal-300x210.jpg 300w, https:\/\/icare-cro.com\/blog\/wp-content\/uploads\/2017\/10\/CORONALE-frontal-768x539.jpg 768w, https:\/\/icare-cro.com\/blog\/wp-content\/uploads\/2017\/10\/CORONALE-frontal.jpg 824w\" sizes=\"auto, (max-width: 149px) 100vw, 149px\" \/><figcaption id=\"caption-attachment-82\" class=\"wp-caption-text\">Sinusite frontale in paziente con poliposi nasale<\/figcaption><\/figure>\n<p><span style=\"font-weight: 400;\">La rinosinusite cronica con o senza polipi nasali ha un impatto socioeconomico negativo; infatti la qualit\u00e0 della vita dei pazienti che soffrono di tale patologia \u00e8 generalmente bassa rispetto alla popolazione generale. Il ruolo della chirurgia \u00e8 ben consolidato e di solito i pazienti trattati con chirurgia\u00a0<\/span><span style=\"font-weight: 400;\">endoscopica naso-sinusale funzionale (FESS, acronimo di functional endoscopic sinus surgery)<\/span><span style=\"font-weight: 400;\">\u00a0mo<\/span><span style=\"font-weight: 400;\">strano una qualit\u00e0 migliorata della vita. Tuttavia, ancora oggi il chirurgo ORL si trova di fronte alla impo<\/span><span style=\"font-weight: 400;\">rtante decisione a quando consigliare la chirurgia al paziente e quanto questa debba essere \u201caggressiva\u201d. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Recentemente, il Massachusetts Eye and Ear Infirmary di Boston[<\/span><span style=\"font-weight: 400;\">1]<\/span><span style=\"font-weight: 400;\"> \u00a0ha pubblicato uno studio riguardante il rapporto costo-efficacia della FESS con e senza sinusotomia frontale per i pazienti con polipi nasali. La terapia medica, anche se economica e facile da applicare, non determina un significativo aumento della qualit\u00e0 della vita. Pertanto, quando necessaria, la FESS dovrebbe essere consigliata anche se i costi previsti sono maggiori alla terapia medica in assenza di complicazioni; ma la qualit\u00e0 della vita migliora in maniera significativa. Inoltre, lo studio sottolinea che la FESS compresa la sinusotomia frontale aggiunge potenziali rischi senza sostanziali miglioramenti del rapporto costo-beneficio soprattutto in termini di qualit\u00e0 della vita.<\/span><\/p>\n<div id=\"text-2\" class=\"widget widget_text amr_widget\">\t\t\t<div class=\"textwidget\"><p><script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script><br \/>\n<!-- Responsive --><br \/>\n<ins class=\"adsbygoogle\" style=\"display: block;\" data-ad-client=\"ca-pub-2279281751910100\" data-ad-slot=\"5949845678\" data-ad-format=\"auto\" data-full-width-responsive=\"true\"><\/ins><br \/>\n<script>\n     (adsbygoogle = window.adsbygoogle || []).push({});\n<\/script><\/p>\n<\/div>\n\t\t<\/div>\n<p><span style=\"font-weight: 400;\">Ma chi sono i pazienti eleggibili per questo tipo di chirurgia?<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Un recente studio, condotto dall\u2019Universit\u00e0 di Bari[<\/span><span style=\"font-weight: 400;\">2]<\/span><span style=\"font-weight: 400;\">, ha \u00a0valutato un approccio terapeutico personalizzato sulla base di una classificazione clinica e dei risultati della citologia nasale.I risultati dello studio hanno dimostrato che una terapia personalizzata, anche nel gruppo di paziente con una situazione grave, permette un controllo fino al \u00a040% dei pazienti trattati senza ricorrere alla chirurgia.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In conclusione, una terapia personalizzata della rinosinusite cronica con polipi permette di ottenere una buona qualit\u00e0 di vita e di ridurre le possibilit\u00e0 di intervenire chirurgicamente. Quando necessaria, la FESS consente di \u00a0ottenere un notevole miglioramento della qualit\u00e0 di vita a lungo termine mentre l\u2019estensione alla senotomia frontale dovrebbe essere solo limitata ai casi con particolarit\u00e0 anatomiche del recesso naso-frontale, alle recidive e ai quadri clinici gravi. L\u2019intervento standard di FESS consente nella stragrande maggioranza dei pazienti di ottenere benefici a lungo termine con minimi rischi intra e post-operatori e rapido recupero alla vita quotidiana.<\/span><\/p>\n<p>Bibliografia<\/p>\n<ol>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Scangas GA, Lehmann AE, Remenschneider AK, Su BM, Shrime MG, Metson R. The value of frontal sinusotomy for chronic rhinosinusitis with nasal polyps-A cost\u00a0<\/span><span style=\"font-weight: 400;\">utility analysis. Laryngoscope. 2017 Aug 16. doi: 10.1002\/lary.26783.<\/span><\/li>\n<li style=\"font-weight: 400;\">Gelardi M, Iannuzzi L, De Giosa M, Taliente S, De Candia N, Quaranta N, De Corso E, Seccia V, Ciprandi G. Non-surgical management of chronic rhinosinusitis\u00a0 with nasal polyps based on clinical-cytological grading: a precision medicine-based approach. Acta Otorhinolaryngol Ital. 2017 Feb;37(1):38-45. doi: 10.14639\/0392-100X-1417.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p><span class=\"span-reading-time rt-reading-time\" style=\"display: block;\"><span class=\"rt-label rt-prefix\">Reading Time: <\/span> <span class=\"rt-time\"> 2<\/span> <span class=\"rt-label rt-postfix\">minutes<\/span><\/span>La terapia medica personalizzata consente di ottenere un buon controllo della sintomatologia nei pazienti con rinosinusite cronica con polipi e basso tasso di ricorso alla chirurgia. L\u2019intervento di chirurgia endoscopica nasosinusale funzionale permette di ottenere notevoli vantaggi sulla qualit\u00e0 di vita con minimi rischi intra e post-operatori. La rinosinusite cronica con o senza polipi nasali&hellip;&nbsp;<a href=\"https:\/\/icare-cro.com\/blog\/2017\/10\/27\/rinosinusite-poliposi-nasale\/\" rel=\"bookmark\">Read More &raquo;<span class=\"screen-reader-text\">Rinosinusite cronica con poliposi nasale: quando e come operare.<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"","neve_meta_content_width":0,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","neve_meta_reading_time":"","footnotes":"","_wpscppro_dont_share_socialmedia":false,"_wpscppro_custom_social_share_image":0,"_facebook_share_type":"","_twitter_share_type":"","_linkedin_share_type":"","_pinterest_share_type":"","_linkedin_share_type_page":"","_instagram_share_type":"","_medium_share_type":"","_threads_share_type":"","_google_business_share_type":"","_bluesky_share_type":"","_mastodon_share_type":"","_selected_social_profile":[],"_wpsp_enable_custom_social_template":false,"_wpsp_social_scheduling":{"enabled":false,"datetime":null,"platforms":[],"status":"template_only","dateOption":"","timeOption":"","customDays":"","customHours":"","customDate":"","customTime":"","schedulingType":""},"_wpsp_active_default_template":true},"categories":[27,22],"tags":[44],"class_list":["post-81","post","type-post","status-publish","format-standard","hentry","category-naso","category-otorinolaringoiatria","tag-sinusite"],"yoast_head":"<!-- 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