NGHIÊN CỨU HÌNH THÁI LÂM SÀNG, NỘI SOI VÀ CẮT LỚP VI TÍNH CỦA BỆNH NHÂN VIÊM MŨI XOANG MẠN TÍNH CÓ CHỈ ĐỊNH PHẪU THUẬT MŨI XOANG TẠI BỆNH VIỆN HỮU NGHỊ VIỆT NAM CU BA

Abstract

Chronic rhinosinusitis (CRS) is defined as inflammation of the nasal and paranasal sinus mucosa lasting for more than 12 weeks. Objective: To analyze the clinical, endoscopic, and computed tomographic characteristics of patients with chronic rhinosinusitis indicated for surgery at Vietnam–Cuba Friendship Hospital. Subjects and Methods: A descriptive case series study was conducted on 65 patients with chronic rhinosinusitis who underwent endoscopic sinus surgery at Vietnam–Cuba Friendship Hospital from July 2024 to August 2025. Results: The most common age group was over 45 years (53.8%); males accounted for 53.8% and females for 46.2%. The most frequent clinical symptoms were nasal obstruction (100%), nasal discharge (96.9%), facial pain or pressure (72.3%), and hyposmia/anosmia (27.7%). Endoscopic findings showed that 100% of patients had nasal mucosal edema and retained secretions in the middle–inferior meatus; 95.4% had edema or obstruction of the osteomeatal complex. The retained secretion was mainly clear to mucoid (87.7%), while purulent discharge was observed in 12.3% of cases. Nasal polyps were detected in 53.9% of patients, with Grade III–IV polyps being the most common (85.7%). Nasal cavity deformities were found in 24.6% of cases, and suspicious tumor-like masses in 4.6%. On CT scans, sinus opacification was most frequently observed in the maxillary sinus (98.5%), followed by the ethmoid (76.9%), frontal (55.4%), and sphenoid sinuses (41.6%). Most patients had multi-sinus involvement (81.5%). The mean Lund–Mackay score was 10.2 ± 5.81, with moderate to severe disease (Grade II–III) accounting for 73.9%. Other CT findings included: osteomeatal complex obstruction (95.4%), nasal cavity mass (52.3%), bony abnormalities (21.5%), fungal sinusitis features (27.7%), and odontogenic sinusitis (4.6%).
Conclusion: Chronic rhinosinusitis indicated for surgery was most common in patients over 45 years old, with no significant gender difference. The most frequent symptoms were nasal obstruction and nasal discharge. Endoscopic findings revealed mucosal edema, osteomeatal complex obstruction, and middle–inferior meatal secretions; most nasal polyps were Grade III–IV. CT imaging demonstrated multi-sinus involvement, predominantly moderate to severe disease by Lund–Mackay scoring, and additional findings such as fungal sinusitis, odontogenic sinusitis, and bony abnormalities.