Lee Jae Yong, Lee Jong Dae
Department of Otorhinolaryngology, Soonchunhyang University College of Medicine, Bucheon, South Korea.
Laryngoscope. 2006 May;116(5):729-34. doi: 10.1097/01.mlg.0000205140.44181.45.
Various surgical methods have been tried to relieve the symptoms of nasal obstruction in patients with inferior turbinate hypertrophy. Recently, coblation that uses the radiofrequency and microdebrider is being increasingly used in turbinate surgery. The aim of this study was to compare the long-term postoperative outcome between the coblation- and microdebrider-assisted partial turbinoplasty.
We selected 60 patients for this prospective study who had nasal obstruction and hypertrophied turbinate mucosa that was refractory to medical treatment. Thirty patients were treated with coblation (group 1) and 30 patients were treated with microdebrider (group 2). Postoperative changes in degree of nasal obstruction were evaluated prospectively at 3, 6, and 12 months after the procedure. A cross-sectional area of second notch and volume of nasal cavity were compared at 12 months after operation. Operation time, duration of crust formation, postnasal drip, and postoperative bleeding were also compared.
Nasal obstruction was improved significantly in both groups at 3, 6, and 12 months after the procedure. However, when compared between two groups, symptom improvement was statistically significant in group 2 at 12 months after surgery. Acoustic rhinometry performed at 12 months demonstrated a significant increase of cross-sectional area of second notch and volume of nasal cavity in group 2 in comparison with group 1. There were no significant differences in degree of postnasal drip, operation time, or duration of crust formation between the two groups.
This study suggests that microdebrider-assisted partial turbinoplasty is more effective and satisfactory in long-term relief of nasal obstruction and reduction in mucosal volume of anterior head of inferior turbinate.
人们尝试了各种手术方法来缓解下鼻甲肥大患者的鼻塞症状。近来,使用射频和微型切割器的低温等离子消融术在鼻甲手术中的应用越来越广泛。本研究的目的是比较低温等离子消融术辅助下的部分鼻甲成形术与微型切割器辅助下的部分鼻甲成形术的术后长期效果。
我们选择了60例因鼻塞和鼻甲黏膜肥大而药物治疗无效的患者进行这项前瞻性研究。30例患者接受低温等离子消融术治疗(第1组),30例患者接受微型切割器治疗(第2组)。术后分别于3、6和12个月对鼻塞程度的变化进行前瞻性评估。比较术后12个月时第二切迹的横截面积和鼻腔容积。同时比较手术时间、结痂持续时间、鼻后滴漏情况和术后出血情况。
两组患者术后3、6和12个月时鼻塞均有明显改善。然而,两组比较时,术后12个月时第2组的症状改善具有统计学意义。术后12个月进行的鼻声反射测量显示,与第1组相比,第2组的第二切迹横截面积和鼻腔容积显著增加。两组在鼻后滴漏程度、手术时间或结痂持续时间方面无显著差异。
本研究表明,微型切割器辅助下的部分鼻甲成形术在长期缓解鼻塞和减少下鼻甲前端黏膜体积方面更有效且更令人满意。