Department of Otolaryngology, Hyogo College of Medicine, Hyogo, Japan.
Allergol Int. 2013 Dec;62(4):479-85. doi: 10.2332/allergolint.12-OA-0533. Epub 2013 Oct 25.
Surgical treatment for inferior turbinate (IT) is selected to treat severe allergic rhinitis (AR) that is unresponsive to conservative treatment. This study aimed to determine the clinical effects of outpatient submucosal IT surgery (OSITS) on patients with severe AR.
Between January 2008 and August 2012, 95 patients with severe AR who underwent OSITS at the Department of Otolaryngology, Hyogo College of Medicine, were retrospectively analyzed. There were 53 men and 42 women. Their mean age was 27 years (11-75 years). OSITS was bilaterally performed using a bipolar radiofrequency electrocautery under local anesthesia. Symptoms, QOL, and physical findings were evaluated using scores from both pre- and postoperative periods (average: 12.4 months), according to Practical Guideline for the Management of AR in Japan 2009.
In perennial AR, all mean scores of nasal symptoms, QOL, and physical findings significantly improved after OSITS (p < 0.05, n = 83). Nasal obstruction, sleep problems, and IT congestion were the most strongly affected. Eye symptoms were not influenced by OSITS. OSITS also showed significant effects on nasal obstruction and IT congestion in seasonal AR (p < 0.05, n = 12), but not sneezing, nasal discharge, and QOL. In terms of the efficacy, OSITS was beneficial in 90% of perennial AR cases and 75% of seasonal AR cases. Epistaxis (1%), vestibulitis (1%), and IT atrophy (4%) were observed after OSITS.
These data indicate that OSITS using radiofrequency electrocautery could be a beneficial therapeutic option in patients with severe AR.
手术治疗下鼻甲（IT）是选择治疗严重的变应性鼻炎（AR），是对保守治疗无反应。本研究旨在确定门诊下鼻甲粘膜下切除术（OSITS）对严重 AR 患者的临床效果。
2008 年 1 月至 2012 年 8 月，在兵库医科大学耳鼻喉科接受 OSITS 的 95 例严重 AR 患者进行回顾性分析。男 53 例，女 42 例。平均年龄 27 岁（11-75 岁）。在局部麻醉下使用双极射频电烙术对双侧进行 OSITS。根据日本 2009 年变应性鼻炎管理实用指南，使用术前和术后评分（平均：12.4 个月）评估症状、生活质量和体格检查结果。
在常年性 AR 中，所有鼻部症状、生活质量和体格检查评分在 OSITS 后均显著改善（p < 0.05，n = 83）。鼻塞、睡眠问题和 IT 充血受影响最大。眼症状不受 OSITS 影响。OSITS 也对季节性 AR 的鼻塞和 IT 充血有显著影响（p < 0.05，n = 12），但对打喷嚏、鼻涕和生活质量没有影响。在疗效方面，OSITS 对常年性 AR 病例的 90%和季节性 AR 病例的 75%有疗效。OSITS 后观察到鼻出血（1%）、前庭炎（1%）和 IT 萎缩（4%）。
这些数据表明，射频电烙术的 OSITS 可能是严重 AR 患者的一种有益的治疗选择。
