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传统与内镜下下鼻甲切除术:技术与结果

Conventional versus endoscopic inferior turbinate reduction: technique and results.

作者信息

Gendeh B S

机构信息

Department of Otorhinolaryngology, Faculty of Medicine, Hospital Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Kuala Lumpur.

出版信息

Med J Malaysia. 2000 Sep;55(3):357-62.

Abstract

Different modalities of turbinate reduction procedures are available for treatment of vasomotor rhinitis not responding to appropriate medical therapy. Amongst these, conventional inferior turbinectomy (non-endoscopic) is the most widely performed procedure. With the advent of nasal endoscopes, inferior turbinoplasty has been gaining popularity worldwide. The purpose of this study was to compare the post-operative complaints and hospital stay of conventional versus endoscopic inferior turbinate reduction techniques performed non-randomly on 15 and 21 patients of vasomotor rhinitis respectively from January 1998 to December 1999 at Hospital Universiti Kebangsaan Malaysia (HUKM). A total of 36 patients (22 males and 14 females) with a mean age of 30.6 years underwent turbinate reduction procedures during this period with a post-operative follow up ranging from 3 months to 6.7 months (mean 3.8 months). There was a significant difference between the conventional and the endoscopic technique with regards to nasal discomfort (p = 0.05) and dry throat (p = 0.02) which was less severe when performed endoscopically. The average hospital stay in hours by the endoscopic technique was almost half compared to the conventional technique. Due to the improved visualisation and minimal post-operative complaints and reduced hospital stay, the technique of endoscopic inferior turbinoplasty is currently the procedure of choice at our center. In septoplasty when endoscopic instrument is not needed, the standard turbinate reduction procedure is still performed. The availability of pre and post-operative acoustic rhinomanometric evaluation will be helpful as an objective measurement of nasal symptoms in the near future.

摘要

对于药物治疗无效的血管运动性鼻炎,有多种下鼻甲缩小手术方式可供选择。其中,传统的下鼻甲切除术(非内镜下)是开展最为广泛的手术。随着鼻内镜的出现,下鼻甲成形术在全球范围内越来越受欢迎。本研究的目的是比较1998年1月至1999年12月期间在马来西亚国民大学医院(HUKM)分别对15例和21例血管运动性鼻炎患者非随机进行的传统与内镜下下鼻甲缩小技术的术后不适情况和住院时间。在此期间,共有36例患者(22例男性和14例女性),平均年龄30.6岁,接受了下鼻甲缩小手术,术后随访时间为3个月至6.7个月(平均3.8个月)。传统技术与内镜技术在鼻不适(p = 0.05)和咽干(p = 0.02)方面存在显著差异,内镜手术时这些症状较轻。内镜技术的平均住院小时数几乎是传统技术的一半。由于视野改善、术后不适最小且住院时间缩短,内镜下下鼻甲成形术目前是我们中心的首选手术。在鼻中隔成形术不需要内镜器械时,仍采用标准的下鼻甲缩小手术。术前和术后的鼻声反射测量评估在不久的将来作为鼻症状的客观测量将很有帮助。

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