Romano Antonio, Orabona Giovanni Dell'Aversana, Salzano Giovanni, Abbate Vincenzo, Iaconetta Giorgio, Califano Luigi
Department of Maxillofacial Surgery, University of Naples "Federico II", Naples, Italy; and Department of Neurosurgery, University of Salerno, Salerno, Italy.
J Craniofac Surg. 2015 May;26(3):e235-8. doi: 10.1097/SCS.0000000000001500.
The purpose of our study was to compare the inferior turbinotomy and the microdebrider-assisted inferior turbinoplasty in patients with hypertrophy of the inferior turbinate.
We carried out a retrospective review of 205 patients, 96 women and 109 men, with a mean age of 48 years, operated on for hypertrophy of the inferior turbinate between May 2005 and May 2012. Forty-seven patients were excluded from our study because in these patients, nasal obstruction was caused by a specific pathologic condition (allergy, tumors or polyps, recurrent rhinosinusitis, etc). The remaining 158 patients were randomly assigned to undergo partial inferior turbinoplasty through the use of microdebrider (group A, n = 79) or partial inferior turbinotomy (group B, n = 79). Surgical outcome was evaluated according to 4 distinct parameters: nasal endoscopic findings, nasal subjective symptoms, anterior rhinomanometry, and nasal mucociliary transport time. These evaluations were made before surgery and 1 week and 3 months after surgery. The follow-up was a minimum of 24 months and a maximum of 60 months, with a mean follow-up of 42 months.
Turbinate edema and secretions decreased significantly (P < 0.05) in groups A and B 3 months after surgery. In group A, crusting was not observed after surgery. In group B, crusting had increased significantly (P < 0.005) 1 week after surgery and then decreased significantly at the third month after surgery. Subjective nasal symptoms including nasal obstruction, sneezing, snoring, itchy nose, hyposmia, headache, and dryness were significantly improved in both groups from the third month after surgery (P < 0.05). Rhinomanometric measurements demonstrated a significant nasal flow increase at 3 months (P < 0.05). The mean nasal mucociliary transport time slightly increased in both groups 1 week after surgery, and then restabilized to preoperative values at the third-month follow-up in both groups (difference not significant).
Microdebrider-assisted inferior turbinoplasty and partial inferior turbinotomy are very effective surgical techniques for solving hypertrophy of the inferior turbinates and therefore related problems of nasal obstruction. Microdebrider-assisted inferior turbinoplasty compared to partial inferior turbinotomy ensures a greater preservation of the nasal mucosa to prevent nasal bleeding.
我们研究的目的是比较下鼻甲切除术与微切割器辅助下鼻甲成形术治疗下鼻甲肥大患者的效果。
我们对205例患者进行了回顾性研究，其中女性96例，男性109例，平均年龄48岁，于2005年5月至2012年5月因下鼻甲肥大接受手术。47例患者被排除在研究之外，因为这些患者的鼻塞是由特定病理状况（过敏、肿瘤或息肉、复发性鼻窦炎等）引起的。其余158例患者被随机分为两组，一组通过使用微切割器进行部分下鼻甲成形术（A组，n = 79），另一组进行部分下鼻甲切除术（B组，n = 79）。根据4个不同参数评估手术效果：鼻内镜检查结果、鼻部主观症状、前鼻测压法和鼻黏膜纤毛运输时间。这些评估在手术前、手术后1周和3个月进行。随访时间最短24个月，最长60个月，平均随访42个月。
A组和B组术后3个月时鼻甲水肿和分泌物显著减少（P < 0.05）。A组术后未观察到结痂现象。B组术后1周结痂显著增加（P < 0.005），但在术后第3个月时显著减少。两组患者术后第3个月起，包括鼻塞、打喷嚏、打鼾、鼻痒、嗅觉减退、头痛和干燥等鼻部主观症状均有显著改善（P < 0.05）。鼻测压测量显示术后3个月时鼻气流显著增加（P < 0.05）。两组患者术后1周时鼻黏膜纤毛平均运输时间略有增加，然后在术后第3个月随访时恢复到术前值（差异无统计学意义）。
微切割器辅助下鼻甲成形术和部分下鼻甲切除术是解决下鼻甲肥大及相关鼻塞问题的非常有效的手术技术。与部分下鼻甲切除术相比，微切割器辅助下鼻甲成形术能更好地保留鼻黏膜以预防鼻出血。
