Supiyaphun Pakpoom, Aramwatanapong Phooripan, Kerekhanjanarong Virachai, Sastarasadhit Veerapong
Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Pathumwan, Bangkok 10330, Thailand.
Auris Nasus Larynx. 2003 Feb;30(1):59-64. doi: 10.1016/s0385-8146(02)00104-9.
Nasal obstruction resulting from inferior turbinate hypertrophy (ITH) was treated with KTP laser inferior turbinoplasty (KIT). The effectiveness of the procedure was assessed.
A prospective clinical trial was carried out in King Chulalongkorn Memorial Hospital from October 1, 1998 to September 30, 2000. Forty-eight patients with chronic nasal obstruction underwent KIT. Nasal obstruction was pre- and postoperatively assessed, based on 4-point scale, by the patient and investigator. The scores were compared by paired t-test. The correlation of assessment by the patient and investigator was also demonstrated by weighted kappa test. Pre- and postoperative rhinomanometric evaluations were performed in 29 patients and were compared with paired t-test.
Significant reduction of nasal obstruction was obtained from assessment by the patient (P<0.000) and by the investigator (P<0.000). The symptoms of sneezing, itching and rhinorrhea were significantly reduced postoperatively (P<0.000). The cure and improvement rate of nasal obstruction were at 70.8 and 100% (assessed by the patient) and at 77.1 and 100% (assessed by the investigator) respectively, and they showed a moderate correlation (Kw=0.65). Rhinomanometrically, the total airway resistance decreased but of not statistic significance (P=0.219), however, the inspired nasal airflow at 150 Pa and the volume of nasal cavities were significantly increased (P<0.00 and P<0.001, respectively).
KIP was shown to effectively reduce the symptom and sign of nasal obstruction as well as other nasal symptoms without any significant complications. It should be an alternative method in treating the patients with nasal obstruction resulting from hyperplastic inferior turbinate.
采用KTP激光下鼻甲成形术(KIT)治疗下鼻甲肥大(ITH)所致的鼻塞,并评估该手术的有效性。
1998年10月1日至2000年9月30日在朱拉隆功国王纪念医院进行了一项前瞻性临床试验。48例慢性鼻塞患者接受了KIT治疗。患者和研究者根据4分制对术前和术后的鼻塞情况进行评估。采用配对t检验比较评分。加权kappa检验也显示了患者和研究者评估结果的相关性。对29例患者进行了术前和术后鼻阻力测量评估,并采用配对t检验进行比较。
患者评估(P<0.000)和研究者评估(P<0.000)均显示鼻塞明显减轻。术后打喷嚏、瘙痒和流涕症状明显减轻(P<0.000)。鼻塞的治愈率和改善率分别为患者评估的70.8%和100%,以及研究者评估的77.1%和100%,两者显示出中度相关性(Kw = 0.65)。鼻阻力测量方面,总气道阻力降低但无统计学意义(P = 0.219),然而,150 Pa时的吸气鼻气流和鼻腔容积显著增加(分别为P<0.00和P<0.001)。
KIP被证明能有效减轻鼻塞症状和体征以及其他鼻部症状,且无任何明显并发症。它应是治疗下鼻甲增生所致鼻塞患者的一种替代方法。