Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece.
Laryngoscope. 2010 Jul;120(7):1453-9. doi: 10.1002/lary.20913.
OBJECTIVES/HYPOTHESIS: To study differences in inferior nasal turbinate (INT) mucosal and submucosal wound-healing histology after radiofrequency tissue ablation (RTA) and monopolar electrocautery (MEC).
Randomized controlled trial.
Experimental study in sheep. Using hematoxylin- and eosin-stained sections, stromal fibrosis, submucosal interstitial space volume (ISV), mucosal epithelial cell necrosis, submucosal inflammation, and vascularization in inferior turbinate samples were compared after RTA and MEC. Twelve turbinate samples were studied for each technique after 1, 3, and 8 weeks postoperatively (four samples at each time point) and there were five samples of controls. A 4-point semiquantitative histologic grading scale (0 = absence, 1 = mild, 2 = medium, 3 = pronounced) was used to assess changes. Comparisons were performed using the Mann-Whitney test and the Kruskal-Wallis one-way analysis of variance (ANOVA).
At postoperative week 8, the RTA group had more extensive fibrosis (P = .061) and ISV reduction (P = .127), less epithelial cell necrosis (P = .131), and significantly less submucosal inflammation (P = .036) and vascularization (P = .011) compared with the MEC group. Epithelial cell necrosis and submucosal inflammation at week 8 did not differ significantly between RTA and control group (P = 1.000 and P = .356, respectively). A significant decrease in submucosal layer vascularization in RTA-treated INTs has been observed (P = .003 compared with controls).
RTA is more effective (although not significantly) and less invasive than MEC for INT volume reduction. Tissue damage and wound healing were dominated by inflammation and associated epithelial cell necrosis in MEC and by a disturbance in the INT submucosal microcirculation in RTA in the studied sheep model.
目的/假设：研究射频组织消融（RTA）和单极电灼（MEC）后下鼻甲（INT）黏膜和黏膜下伤口愈合组织学的差异。
随机对照试验。
绵羊的实验研究。使用苏木精和伊红染色切片，比较 RTA 和 MEC 后下鼻甲样本中的基质纤维化、黏膜下间质空间体积（ISV）、黏膜上皮细胞坏死、黏膜下炎症和血管化。每种技术在术后 1、3 和 8 周后研究了 12 个鼻甲样本（每个时间点 4 个样本），并设有 5 个对照样本。使用 4 分制半定量组织学分级量表（0 = 不存在，1 = 轻度，2 = 中度，3 = 重度）评估变化。使用 Mann-Whitney 检验和 Kruskal-Wallis 单向方差分析（ANOVA）进行比较。
在术后第 8 周，RTA 组的纤维化程度更广泛（P =.061），ISV 减少（P =.127），上皮细胞坏死较少（P =.131），黏膜下炎症（P =.036）和血管化（P =.011）明显减少。与 MEC 组相比，RTA 组和对照组在第 8 周时的上皮细胞坏死和黏膜下炎症无显著差异（P = 1.000 和 P =.356）。在 RTA 治疗的 INT 中观察到黏膜下层血管化显著减少（与对照组相比，P =.003）。
与 MEC 相比，RTA 更有效（尽管不显著）且对 INT 体积减少的侵袭性更小。在研究的绵羊模型中，MEC 中组织损伤和伤口愈合主要由炎症和相关的上皮细胞坏死引起，而 RTA 则由 INT 黏膜下微循环紊乱引起。
