Bergler W F, Sadick H, Hammerschmitt N, Oulmi J, Hörmann K
Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Mannheim, Mannheim, Germany.
Laryngoscope. 2001 Sep;111(9):1593-8. doi: 10.1097/00005537-200109000-00019.
Surgical reduction of the inferior turbinates is a commonly used therapy in patients with hyperplastic inferior turbinates when medical management remains ineffective. Current surgical methods have disadvantages (e.g., necessity of nasal packing, extended postoperative swelling, and high costs). Theoretical considerations render argon plasma coagulation (APC) a promising new therapeutic approach.
In a prospective study, 121 patients with chronic nasal obstruction were treated for inferior turbinate reduction with APC. Hyperplasia of the nasal turbinates was diagnosed rhinoscopically and endoscopically and confirmed rhinomanometrically. The mean follow-up period was 12 months, ranging from 10 to 16 months. The treatment results were evaluated by a questionnaire, rhinomanometric findings, and electron microscopic studies of the nasal mucosa. In 50 patients a ciliary function test was performed preoperatively and postoperatively.
Argon plasma coagulation, a high-frequency electrosurgery, has been used for volume reduction of the inferior turbinate in local anesthesia.
Seventy-six percent of the patients reported an improvement of the postoperative swelling within the first week. After 6 weeks, macroscopically the turbinates were re-epithelialized by normal mucosa in 63% of the patients. Electron microscopic studies after 3 months verified normal cilia. After 12 months, 83% of the patients stated that they had a better nasal airflow than preoperatively. Crust formation was minimal. No bleeding or impaired ciliary function occurred. Ninety-five percent of the patients were willing to undergo the same operation again.
The long-term results have proved APC to be an effective and easy-to-perform alternative for inferior turbinate reduction with comparable results to other established surgical methods.
当药物治疗无效时，下鼻甲手术缩小术是增生性下鼻甲患者常用的治疗方法。目前的手术方法存在缺点（例如，需要鼻腔填塞、术后肿胀时间延长和费用高昂）。理论上，氩等离子体凝固术（APC）是一种有前景的新治疗方法。
在一项前瞻性研究中，121例慢性鼻阻塞患者接受了APC下鼻甲缩小术治疗。通过鼻内镜和内镜检查诊断鼻甲增生，并通过鼻阻力测量法进行确认。平均随访期为12个月，范围为10至16个月。通过问卷调查、鼻阻力测量结果和鼻黏膜电子显微镜研究评估治疗效果。50例患者术前和术后进行了纤毛功能测试。
氩等离子体凝固术是一种高频电外科手术，已用于在局部麻醉下缩小下鼻甲体积。
76%的患者报告术后第一周内肿胀有所改善。6周后，63%的患者鼻甲在宏观上被正常黏膜重新上皮化。3个月后的电子显微镜研究证实纤毛正常。12个月后，83%的患者表示他们的鼻腔气流比术前更好。结痂形成极少。未发生出血或纤毛功能受损。95%的患者愿意再次接受相同手术。
长期结果证明，APC是一种有效且易于实施的下鼻甲缩小术替代方法，其效果与其他既定手术方法相当。
