Utley D S, Goode R L, Hakim I
Division of Otolaryngology/Head and Neck Surgery, Stanford University Medical Center, Palo Alto, California, USA.
Laryngoscope. 1999 May;109(5):683-6. doi: 10.1097/00005537-199905000-00001.
OBJECTIVE/HYPOTHESIS: We hypothesized that the success rate of radiofrequency energy (RFe) tissue ablation of the inferior turbinate for nasal obstruction achieved by previous investigators would be improved by using a longer needle electrode and creating two lesions per turbinate.
Ten patients with nasal obstruction secondary to inferior turbinate hypertrophy were prospectively enrolled. A 40-mm needle delivered RFe to two sites in each inferior turbinate. Patients used a visual analog scale (VAS) to grade nasal obstruction preoperatively and at 1 week and 8 weeks after surgery. Preoperative and postoperative digital images of the nasal cavity were graded for obstruction (0% to 100%) in a blinded manner.
All patients (100%) were subjectively improved at 8 weeks. Mean obstruction (VAS) improved from 50%+/-21% to 16%+/-15% (right side) and from 53%+/-29% to 13%+/-13% (left side). Mean improvements were 68% (right side) (P = .004) and 75% (left side) (P = .001). Mean obstruction graded during blinded review of nasal cavity images improved from 73.5%+/-8% to 51%+/-8% (right side) and from 76%+/-6% to 64%+/-7% (left side). Of nine patients using medications for nasal obstruction before treatment, eight (89%) noted no further need for medications at 8 weeks.
The use of RFe for submucosal tissue ablation in the hypertrophied inferior turbinate is an effective modality for reducing symptoms of nasal obstruction. Improved results may occur by using a longer needle and creating two lesions per turbinate. Of patients in this study, 100% reported improvement of nasal obstruction.
目的/假设:我们推测,通过使用更长的针状电极并在每个鼻甲上制造两个病灶,先前研究者所实现的射频能量(RFe)下鼻甲组织消融治疗鼻塞的成功率将会提高。
前瞻性纳入10例因下鼻甲肥大导致鼻塞的患者。使用40毫米的针将RFe输送至每个下鼻甲的两个部位。患者在术前、术后1周和8周使用视觉模拟量表(VAS)对鼻塞程度进行评分。以盲法对术前和术后鼻腔的数字图像进行鼻塞程度分级(0%至100%)。
所有患者(100%)在8周时主观症状均有改善。平均鼻塞程度(VAS)从右侧的50%±21%改善至16%±15%,左侧从53%±29%改善至13%±13%。平均改善率右侧为68%(P = 0.004),左侧为75%(P = 0.001)。在对鼻腔图像进行盲法评估时,平均鼻塞程度从右侧的73.5%±8%改善至51%±8%,左侧从76%±6%改善至64%±7%。在治疗前使用鼻塞药物的9例患者中,8例(89%)在8周时表示无需再使用药物。
使用RFe对肥大的下鼻甲进行黏膜下组织消融是减轻鼻塞症状的有效方法。使用更长的针并在每个鼻甲上制造两个病灶可能会取得更好的效果。本研究中的患者100%报告鼻塞症状有所改善。