Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2026 Jul;40(7):624-629. doi: 10.13201/j.issn.2096-7993.2026.07.005.
ABSTRACT
Objective:To investigate the clinical efficacy of endoscopic ethmoid infundibulum expansion surgery（EEIES） combined with Stapokibart in the treatment of type 2 chronic rhinosinusitis with nasal polyps（CRSwNP）. Methods:A prospective, randomized, single-blind, self-controlled study was conducted. A total of 18 patients with bilateral CRSwNP and type 2 inflammatory phenotype admitted to the Department of Otorhinolaryngology Head and Neck Surgery in our hospital from April 2025 to August 2025 were enrolled. Patients’ bilateral nasal cavities were randomly assigned to undergo either EEIES or full-house endoscopic sinus surgery（full-house ESS）. EEIES described in this study refers to precise ventilation reconstruction of the middle/superior meatus centered on the ethmoid infundibulum. All patients received routine treatments including nasal corticosteroids and nasal irrigation postoperatively. Subcutaneous injection of Stapokibart 300 mg was administered every 2 weeks starting at 2 weeks after surgery for 24 consecutive weeks. The nasal symptom visual analogue scale（VAS）, sino-nasal outcome test-22（SNOT-22） score, nasal polyp score（NPS）, Lund-Kennedy score of nasal endoscopy, and sinus CT Lund-Mackay score were compared before and 24 weeks after surgery, and the efficacy differences between the two surgical procedures were analyzed. Results:At 24 weeks postoperatively, all scores of patients were significantly improved compared with preoperative baseline（all P<0.01）. The NPS, Lund-Kennedy score, and Lund-Mackay score were significantly improved in both EEIES side and full-house ESS side compared with baseline（all P<0.01）, with no statistically significant differences between the two sides（all P>0.05）. Conclusion:The short-term clinical efficacy of EEIES combined with Stapokibart in the treatment of type 2 CRSwNP is comparable to that of full-house ESS combined with Stapokibart. EEIES can precisely alleviate ventilation disorders and the hypoxic microenvironment in the middle and superior nasal meatus, while maximizing preservation of the natural sinus ostium and integrity of the sinus mucosa. Combined with Stapokibart, it can effectively block the type 2 inflammatory pathway and promote nasal mucosal homeostasis reconstruction. The restoration of sinus ventilation and drainage function critically depends on the recovery and integrity of nasal mucosal ciliary function, rather than mechanical enlargement of the sinus ostium. Therefore, EEIES can provide a more minimally invasive and biologically rational surgical treatment option for patients with type 2 CRSwNP.
PMID:42402680 | DOI:10.13201/j.issn.2096-7993.2026.07.005
