TỔNG QUAN VỀ VIÊM MŨI XOANG MẠN TÍNH Ở NGƯỜI CAO TUỔI

Abstract

Chronic rhinosinusitis (CRS) in the elderly is often challenging to treat, each course of treatment is prolonged, and the disease often recurs because of underlying diseases such as diabetes, kidney failure, chronic bronchitis, and COPD., weakened immune system… with a higher risk of complications from acute inflammation. Treatment of CRS in the elderly has many views, especially regarding the long-term use of corticosteroids and antibiotics. To have a better overview of the treatment methods of CRS in the elderly and help otolaryngologists consider, evaluate, and give appropriate treatment indications for the elderly group with chronic rhinosinusitis, we conducted a review of CRS pathology in the elderly. Results: 36 articles met research standards. Long-term medical treatment with low-dose antibiotics, safe for the kidneys, is preferred. Age plays an essential role in the pathophysiology, symptoms, severity, and outcome of CRS treatment. Some related factors: The nasopharynx microbiota in patients over 65 who underwent differential endoscopic sinus surgery. Functional endoscopic sinus surgery in elderly subjects should still be performed when indicated. There was no difference in complication rates when risk factors were controlled (p = 0.89); however, the rate of postoperative infection was higher in the elderly group. Risk factors for complications in elderly patients undergoing endoscopic sinus surgery are uncontrolled comorbidities, especially diabetes and ischemic heart disease. SNOT-20 had a 64% improvement in symptom score at 3 months, 73% improvement at 6 months and 75% at 12 months, with very few intraoperative complications. QoL improved significantly after surgical treatment (p = 0.001) and had a successful response to treatment similar to younger patients (p = 0.74). Regarding the possibility of recurrence, in the multivariate analysis, there was no difference between the elderly and young groups.