Parida Pradipta Kumar, Surianarayanan Gopalakrishnan, Alexander Arun, Saxena Sunil Kumar, Santhosh Krishnapriya
Department of E.N.T, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry, 605006 India.
Indian J Otolaryngol Head Neck Surg. 2013 Aug;65(Suppl 2):350-5. doi: 10.1007/s12070-012-0515-8. Epub 2012 Feb 19.
To evaluate the efficacy of diode laser turbinate reduction procedure in treatment of symptomatic inferior turbinate hypertrophy (ITH) and to study the effect of it on mucociliary clearance of nose. This prospective study was carried out over 45 patients with symptomatic ITH refractory to medical management from July 2009 to March 2010 in Department of E.N.T, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry, India. Each symptom (nasal obstruction, rhinorrhoea, sneezing, headache, hyposmia and snoring) was assessed by visual analogue scale (VAS). Mucociliary clearance was measured by saccharin transit time (STT). All patients underwent diode laser turbinate reduction (LTR) under local anesthesia. The patients were followed up at 1 week, 1, 3 and 6 months postoperatively. During each follow up visit, symptoms were reassessed by VAS score. Difference between preoperative and postoperative VAS score was statistically significant. All patients had significant symptomatic improvement which started from 1 week postoperatively and persisted throughout the follow up period. Prolongation of STT following diode laser turbinate reduction was significant. SST returned back to preoperative value by the end of 6 months. Crusting and pain were the main postoperative complaints. Diode laser turbinate reduction is safe, minimally invasive and effective in relieving the symptoms associated with ITH and can be performed on a day care basis under local anaesthesia. Longer follow up is required to assess the development of late complications and recurrence of symptoms after LTR.
评估半导体激光下鼻甲消融术治疗症状性下鼻甲肥大（ITH）的疗效，并研究其对鼻腔黏液纤毛清除功能的影响。这项前瞻性研究于2009年7月至2010年3月在印度本地治里贾瓦哈拉尔·尼赫鲁研究生医学教育与研究学院耳鼻喉科对45例药物治疗无效的症状性ITH患者进行。通过视觉模拟量表（VAS）对每种症状（鼻塞、流涕、打喷嚏、头痛、嗅觉减退和打鼾）进行评估。通过糖精转运时间（STT）测量黏液纤毛清除功能。所有患者均在局部麻醉下接受半导体激光下鼻甲消融术（LTR）。术后1周、1、3和6个月对患者进行随访。在每次随访时，通过VAS评分重新评估症状。术前和术后VAS评分差异具有统计学意义。所有患者症状均有显著改善，术后1周开始，且在整个随访期间持续存在。半导体激光下鼻甲消融术后STT延长显著。6个月末SST恢复到术前值。结痂和疼痛是术后主要的主诉。半导体激光下鼻甲消融术安全、微创，能有效缓解ITH相关症状，可在局部麻醉下于日间手术进行。需要更长时间的随访来评估LTR术后晚期并发症的发生和症状复发情况。
