Orhan Israfil, Dogan Remzi, Soylu Erkan, Aksoy Fadlullah, Veyseller Bayram, Ozturan Orhan, Esrefoglu Mukaddes, Aydın Mehmet Serif
Department of Otorhinolaryngology, Kahramanmaras Sutcu Imam University Medical Faculty, Kahramanmaras, Turkey.
Bayrampasa State Hospital, Department of Otorhinolaryngology, Bayrampasa, Istanbul, Turkey.
Int J Pediatr Otorhinolaryngol. 2015 Mar;79(3):305-9. doi: 10.1016/j.ijporl.2014.11.015. Epub 2014 Dec 15.
The purpose of this study was to assess the use of Ankaferd blood stopper (ABS), an organic hemostatic agent of plant origin, in septoplasty operations, and to determine its effect on nasal septal tissues in the rabbit model.
The study was performed on 30 New Zealand adult male rabbits each weighing 2500-3500g (average: 3000g). The rabbits were randomly divided into 4 groups, namely, the control group (without septoplasty), the septoplasty+tampon group, the septoplasty+ABS group, and the septoplasty+tampon+ABS group. All animals were sacrificed after two weeks, and the nasal septums were total removed using the lateral rhinotomy technique. The specimens were obtained from similar sites of cartilaginous nasal septum. The sections were stained with hematoxylin-eosin and Mason trichrome stains and studied under the light microscope by the same pathologist who evaluated the mucosal ulcerations, the severity of inflammatory cell infiltration, the mucosal thickness, and the cartilage thickness. The data obtained were statistically analyzed using the Kruskal-Wallis variance analysis and the Mann-Whitney U test.
No mucosal ulceration or inflammatory cell infiltration was detected in any of the rabbit groups. There was a statistically significant difference between the groups in terms of mucosal thickness and cartilage thickness (p<0.05). The values of mucosal thickness in the groups mentioned above were 147.7±17.6μm, 205.7±36.7μm, 139.6±14.8μm, and 190.2±17.5μm, respectively. The values of cartilage thickness were 398.2±28.9μm, 546.2±35.3μm, 363.7±24.7μm, and 447.8±28.2μm, respectively. There was no significant difference between the control group and the septoplasty+ABS group in terms of mucosal thickness and cartilage thickness (p>0.05). However, there was a significant increase in nasal mucosal and cartilage thickness in tampon-using groups when compared with the other groups (p<0.05).
Although nasal tampons provide the contact of mucoperichondrium with the cartilage, they are generally accepted as a discomfort for patients. Ankaferd blood stopper can be used instead of nasal tampons to increase patient comfort.
本研究旨在评估植物源性有机止血剂安卡福得止血剂（ABS）在鼻中隔成形术中的应用，并确定其在兔模型中对鼻中隔组织的影响。
对30只体重2500 - 3500克（平均3000克）的成年新西兰雄性兔进行研究。将兔子随机分为4组，即对照组（未行鼻中隔成形术）、鼻中隔成形术+棉塞组、鼻中隔成形术+ABS组和鼻中隔成形术+棉塞+ABS组。两周后处死所有动物，采用鼻侧切开术技术完整切除鼻中隔。标本取自鼻中隔软骨的相似部位。切片用苏木精-伊红和马森三色染色，由同一位病理学家在光学显微镜下观察，评估黏膜溃疡、炎症细胞浸润程度、黏膜厚度和软骨厚度。所得数据采用Kruskal-Wallis方差分析和Mann-Whitney U检验进行统计学分析。
在任何兔组中均未检测到黏膜溃疡或炎症细胞浸润。各组在黏膜厚度和软骨厚度方面存在统计学显著差异（p<0.05）。上述各组的黏膜厚度值分别为147.7±17.6μm、205.7±36.7μm、139.6±14.8μm和190.2±17.5μm。软骨厚度值分别为398.2±28.9μm、546.2±35.3μm、363.7±24.7μm和447.8±28.2μm。对照组和鼻中隔成形术+ABS组在黏膜厚度和软骨厚度方面无显著差异（p>0.05）。然而，与其他组相比，使用棉塞的组鼻黏膜和软骨厚度有显著增加（p<0.05）。
尽管鼻棉塞可使黏软骨膜与软骨接触，但通常被认为会给患者带来不适。安卡福得止血剂可替代鼻棉塞使用，以提高患者舒适度。
