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射频热消融与“冷钢”用于耳前窦耳上切除的比较研究

Radiofrequency thermal ablation versus 'cold steel' for supra-auricular excision of preauricular sinus: comparative study.

作者信息

Bajwa H, Kumar S

机构信息

Department of ENT-Head and Neck Surgery, Lady Hardinge Medical College, Delhi, India.

出版信息

J Laryngol Otol. 2010 Nov;124(11):1190-3. doi: 10.1017/S0022215110001222. Epub 2010 Jun 11.

Abstract

OBJECTIVE

To compare the results of radiofrequency thermal ablation versus 'cold steel' excision, for supra-auricular excision of preauricular sinus.

STUDY DESIGN

Prospective study. Observations included recurrence, intra-operative bleeding, operation time and ease of dissection.

SETTING

Tertiary referral hospital.

SUBJECTS AND METHODS

Sixty cases of preauricular sinus were assigned randomly to two groups (30 cases each). Group one patients underwent cold steel sinus excision, whereas group two patients underwent radiofrequency-assisted sinus excision.

RESULTS

Fifty patients were operated upon, with a mean age of 12.26 years. Most patients were aged between zero and five years (40 per cent). The average patient follow-up time was 15 months (range, six to 24 months). Recurrence rates were 23 per cent in group one and 3 per cent in group two; this difference was statistically significant (p = 0.016). Dissection of the sinus tract was reported to be much easier in the radiofrequency group, compared with the cold steel group (p = 0.023), with minimal bleeding.

CONCLUSION

From our observations, radiofrequency-assisted, local, wide excision appears to be preferable for treatment of preauricular sinus, compared with cold steel excision, as it allows better peri-operative visualisation, easier dissection, minimal bleeding and a lower subsequent recurrence rate (3.3 per cent).

摘要

目的

比较射频热消融术与“冷钢”切除术治疗耳前窦耳上部分切除的效果。

研究设计

前瞻性研究。观察指标包括复发情况、术中出血、手术时间及解剖难易程度。

研究地点

三级转诊医院。

研究对象与方法

60例耳前窦患者随机分为两组(每组30例)。第一组患者接受冷钢窦切除术,而第二组患者接受射频辅助窦切除术。

结果

50例患者接受了手术,平均年龄为12.26岁。大多数患者年龄在0至5岁之间(40%)。患者平均随访时间为15个月(范围为6至24个月)。第一组的复发率为23%,第二组为3%;差异具有统计学意义(p = 0.016)。据报告,与冷钢组相比,射频组的窦道解剖要容易得多(p = 0.023),出血极少。

结论

根据我们的观察,与冷钢切除术相比,射频辅助局部广泛切除术似乎更适合治疗耳前窦,因为它能在围手术期提供更好的视野、更易于解剖、出血极少且后续复发率较低(3.3%)。

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