Assanasen Paraya, Choochurn Panyalak, Banhiran Wish, Bunnag Chaweewan
Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Allergy Rhinol (Providence). 2014 Mar;5(1):12-6. doi: 10.2500/ar.2014.5.0077. Epub 2014 Mar 7.
Radiofrequency inferior turbinate reduction (RFITR) of inferior turbinate hypertrophy (ITH) is an effective way to treat patients with intractable nasal mucosal obstruction. The objective of this study was to assess smell ability, nasal symptoms, inferior turbinate grading (ITG), peak nasal inspiratory flow (PNIF) of patients with chronic rhinitis (CR), and ITH before and after RFITR. Patients with CR and ITH, aged 18-60 years, who underwent RFITR, were prospectively recruited. Smell ability (measured by smell detection threshold [SDT]), visual analog scale (VAS) of nasal symptoms, ITG, and PNIF before and 6-10 weeks after RFITR were compared. Forty-eight subjects were included. All nasal symptoms were significantly decreased after RFITR. After surgery, SDT (tested by phenyl ethyl alcohol) was worsened in 7 patients (14.6%), improved in 8 patients (16.7%), and did not change in 33 patients (68.7%). SDT after RFITR of six patients in the worsened SDT group were still within normal range (> -6.5). There was only one patient whose SDT changed from normosmia to mild hyposmia (-7.25 to -5.38). In the improved SDT group, two of eight patients had obviously better SDT after RFITR, which changed from moderate hyposmia to normosmia (-3.65 to -10; -3.73 to -10), whereas six of eight patients had little better SDT after RFITR. RFITR also significantly reduced ITG and improved PNIF. In conclusion, the treatment of patients with CR and ITH with RFITR significantly improved PNIF, ITG, and nasal symptoms assessed by VAS, although SDT after RFITR could be the same or improved or worsened.
射频下鼻甲缩小术（RFITR）治疗下鼻甲肥大（ITH）是治疗顽固性鼻粘膜阻塞患者的有效方法。本研究的目的是评估慢性鼻炎（CR）合并ITH患者在RFITR前后的嗅觉能力、鼻部症状、下鼻甲分级（ITG）、鼻腔最大吸气流量（PNIF）。前瞻性招募了18 - 60岁接受RFITR的CR合并ITH患者。比较了RFITR术前和术后6 - 10周的嗅觉能力（通过嗅觉检测阈值[SDT]测量）、鼻部症状视觉模拟量表（VAS）、ITG和PNIF。纳入48名受试者。RFITR后所有鼻部症状均显著减轻。术后，7例患者（14.6%）的SDT（用苯乙醇测试）恶化，8例患者（16.7%）改善，33例患者（68.7%）未改变。SDT恶化组中6例患者RFITR后的SDT仍在正常范围内（> -6.5）。只有1例患者的SDT从嗅觉正常变为轻度嗅觉减退（-7.25至-5.38）。在SDT改善组中，8例患者中有2例在RFITR后SDT明显改善，从中度嗅觉减退变为嗅觉正常（-3.65至-10；-3.73至-10），而8例患者中有6例在RFITR后SDT改善不明显。RFITR还显著降低了ITG并改善了PNIF。总之，RFITR治疗CR合并ITH患者显著改善了PNIF、ITG以及VAS评估的鼻部症状，尽管RFITR后的SDT可能不变、改善或恶化。
