Passàli Desiderio, Passàli Francesco Maria, Damiani Valerio, Passàli Giulio Cesare, Bellussi Luisa
Department of Otorhinolaryngology, University of Siena, Medical School, Siena, Italy.
Ann Otol Rhinol Laryngol. 2003 Aug;112(8):683-8. doi: 10.1177/000348940311200806.
In the past 130 years, many surgical procedures for turbinate reduction have been developed. We analyzed the long-term efficacy of 6 of these surgical techniques (turbinectomy, laser cautery, electrocautery, cryotherapy, submucosal resection, and submucosal resection with lateral displacement) over a 6-year follow-up period. We randomly divided 382 patients into 6 therapeutic groups and surgically treated them at the Department of Otorhinolaryngology of the University of Siena. After 6 years, only submucosal resection resulted in optimal long-term normalization of nasal patency and in restoration of mucociliary clearance and local secretory IgA production to a physiological level with few postoperative complications (p < .001). The addition of lateral displacement of the inferior turbinate improved the long-term results. We recommend, in spite of the greater surgical skill required, submucosal resection combined with lateral displacement as the first-choice technique for the treatment of nasal obstruction due to hypertrophy of the inferior turbinates.
在过去的130年里,已经开发出许多下鼻甲切除术。我们分析了其中6种手术技术(鼻甲切除术、激光烧灼术、电烧灼术、冷冻疗法、黏膜下切除术以及带侧向移位的黏膜下切除术)在6年随访期内的长期疗效。我们将382例患者随机分为6个治疗组,并在锡耶纳大学耳鼻喉科对他们进行了手术治疗。6年后,只有黏膜下切除术能使鼻腔通畅长期达到最佳的正常化状态,并使黏液纤毛清除功能和局部分泌型IgA产生恢复到生理水平,且术后并发症较少(p < 0.001)。下鼻甲侧向移位术的加入改善了长期效果。尽管需要更高的手术技巧,我们仍推荐黏膜下切除术联合侧向移位术作为治疗下鼻甲肥大所致鼻塞的首选技术。