Orabi Ahmad A, Sen Aloke, Timms Michael S, Morar Pradeep
East Lancashire Hospitals, England, United Kingdom.
Am J Rhinol. 2007 Mar-Apr;21(2):198-202. doi: 10.2500/ajr.2007.21.3004.
The aim of this study was to determine patient satisfaction and feasibility of performing KTP laser inferior turbinectomy under topical anesthetic/decongestant spray. A prospective survey study was performed in the Outpatients' Department of a District General Hospital.
Thirty-nine consecutive patients suffering from allergic or nonallergic vasomotor rhinitis were prospectively entered into the study. Preoperative details were gathered including current nasal obstruction score as indicated on a visual analog score (VAS). Lidocaine hydrochloride 5% w/v and phenylephrine hydrochloride 0.5% w/v was applied via topical spray to anesthetize and decongest the nose. The inferior turbinates (ITs) were reduced by parallel mucosal cuts using the KTP laser. Intraoperative details were recorded included pain experienced and bleeding. We studied the subjective clinical effectiveness and patient satisfaction.
All patients were followed up at standard intervals by telephone over a 6-month period. At each interval, current nasal obstruction, pain, bleeding, and crusting on VAS were collected. Morbidity was determined in terms of return to work, return to hospital, or recurrence of symptoms. At the end of 6 months all patients were asked if they would have the procedure repeated again and/or recommend it to a friend. Reduction of ITs under topical anesthesia was acceptable to 83% of all patients. Eighty-seven percent of all patients felt they would recommend the procedure and mode of anesthesia to a friend. Our patients obtained the maximum subjective benefit at 6 weeks postoperatively. A significant improvement in nasal obstruction was achieved. There was subjective improvement in associated symptoms including hyposmia/anosmia, rhinorrhea, and sneezing. Only 28% of all patients required medication again to aid symptom control. Postoperative bleeding was insignificant. The return to a ward or clinic was minimal and 82% of all employed patients were back at work within a week.
Our study showed that KTP laser inferior turbinectomy is suitable to be performed in the outpatient department under topical anesthetic/decongestant spray and provides excellent relief for nasal obstruction and high patient compliance and satisfaction.
本研究的目的是确定在局部麻醉/减充血剂喷雾下进行KTP激光下鼻甲切除术时患者的满意度及可行性。在一家区综合医院的门诊部进行了一项前瞻性调查研究。
39例连续患有过敏性或非过敏性血管运动性鼻炎的患者被前瞻性纳入研究。收集术前详细信息，包括视觉模拟评分（VAS）所示的当前鼻塞评分。通过局部喷雾应用5% w/v盐酸利多卡因和0.5% w/v盐酸去氧肾上腺素对鼻腔进行麻醉和减充血。使用KTP激光通过平行黏膜切口缩小下鼻甲。记录术中详细信息，包括所经历的疼痛和出血情况。我们研究了主观临床疗效和患者满意度。
在6个月期间，所有患者均按标准间隔通过电话进行随访。在每个间隔期，收集VAS上的当前鼻塞、疼痛、出血和结痂情况。根据恢复工作、返回医院或症状复发情况确定发病率。在6个月末，询问所有患者是否愿意再次接受该手术和/或将其推荐给朋友。83%的患者接受局部麻醉下的下鼻甲缩小术。87%的患者认为他们会将该手术及麻醉方式推荐给朋友。我们的患者在术后6周获得了最大主观益处。鼻塞情况有显著改善。包括嗅觉减退/嗅觉丧失、鼻漏和打喷嚏在内的相关症状有主观改善。仅28%的患者需要再次用药以辅助症状控制。术后出血不明显。返回病房或诊所的情况极少，82%的在职患者在一周内恢复工作。
我们的研究表明，KTP激光下鼻甲切除术适合在门诊部在局部麻醉/减充血剂喷雾下进行，可为鼻塞提供极佳缓解，患者依从性和满意度高。
