Chevretton E B, Hopkins C, Black I M, Tierney P, Smeeton N C
Department of Otolaryngology, Guy's and St. Thomas' Hospital, London, UK.
J Laryngol Otol. 2003 Nov;117(11):866-70. doi: 10.1258/002221503322542863.
A pilot study to assess the safety and efficacy of 'degloving' of the inferior turbinate is described. This prospective study reports on the effectiveness of the technique in 37 patients with nasal obstruction due to inferior turbinate hypertrophy. Both objective and subjective measurements of nasal patency were made pre-operatively, and repeated at six weeks, six months and two years post-operatively using nasal inspiratory peak flow rates, saccharin clearance time and an end referenced visual analogue scale to record nasal symptoms. There was a significant improvement in the peak inspiratory flow at six weeks (96.4 to 151.2 l/min) and at six months (148.4 l/min), which was sustained at two years (117.1 l/min, p<0.001). There was an overall improvement in patient satisfaction with nasal symptoms (23.4 to 76.7, 76.8 and 66.8 at six weeks, six months and two years, p<0.001) and a decrease in the sensation of nasal obstruction (71.9 to 21.5, 32.9 and 29.8, p<0.001), which was also sustained. Rhinorrhoea was reduced, and sense of smell increased across the group, but the improvements did not reach statistical significance. The results for postnasal drip and saccharin clearance did not show a significant change over the period of the study. There were no haemorrhagic complications in the group studied. This pilot study demonstrates a new surgical technique for reduction of the inferior turbinates, that yields significant improvement in nasal obstruction, an acceptably low complication rate and is well tolerated by patients. A randomized controlled trial is being planned.
本文描述了一项评估下鼻甲“去套状剥离术”安全性和有效性的初步研究。这项前瞻性研究报告了该技术对37名下鼻甲肥大所致鼻塞患者的疗效。术前对鼻腔通畅程度进行了客观和主观测量，并在术后六周、六个月和两年时使用鼻吸气峰流速、糖精清除时间以及以终点为参照的视觉模拟量表来记录鼻部症状，从而进行重复测量。六周时（从96.4升至151.2升/分钟）及六个月时（148.4升/分钟）吸气峰值流速有显著改善，两年时仍保持这一水平（117.1升/分钟，p<0.001）。患者对鼻部症状的满意度总体有所提高（六周、六个月和两年时分别为23.4至76.7、76.8和66.8，p<0.001），鼻塞感减轻（从71.9降至21.5、32.9和29.8，p<0.001），且这种改善也得以持续。全组患者的鼻漏减少，嗅觉增强，但改善未达到统计学意义。研究期间，鼻后滴漏和糖精清除结果未显示出显著变化。研究组未出现出血并发症。这项初步研究证明了一种新的下鼻甲缩小手术技术，该技术能显著改善鼻塞，并发症发生率低且患者耐受性良好。目前正在计划进行一项随机对照试验。
