Eren Sabri Baki, Yenigun Alper, Tugrul Selahattin, Goktas Seda Sezen, Dogan Remzi, Calim Omer Faruk, Ozturan Orhan
Department of Otorhinolaryngology, Faculty of Medicine, Bezmialem Vakif University, Fatih, Istanbul, Turkey.
J Craniofac Surg. 2017 Jan;28(1):e94-e96. doi: 10.1097/SCS.0000000000003307.
It was revealed that the thiol compound named mesna chemically softens the connective tissue with submucosal injection, and facilitates the endoscopic submucosal dissection. The authors aimed to investigate the effect of mesna injection on mucoperichondrial elevation during septoplasty operation.
This study was planned as a patient-control study and performed. Fifty-six patients who had septoplasty operation were divided into 2 groups that are submucosal mesna (group 1) and submucosal saline (group 2) applied ones. In both groups, the measurement was initiated by a timer during the start of septal incision and elevation processes. After bilateral subperichondrial and subperiostal elevation were finished, timer was stopped and time was recorded. After that, mucosal integrity was reviewed and mucosal damage status was recorded. The difficulty of mucoperichondrial elevation for the surgeon was recorded for each patient.
Twenty-five (44.7%) of the patients who participated in our study were females while 31 (55.3%) were males. The average elevation periods were 201.4 ± 74.3 seconds in group 1 and 260.2 ± 84.1 seconds in group 2. In mesna applied patients, elevation period was statistically and significantly shorter (P = 0.009). Impairment in mucosal integrity was observed as 33.3% in group 1 and 58.8% in group 2. In mesna applied patients, significantly less impairment in mucosal integrity was observed (P = 0.031). The average mucoperichondrial elevation difficulty for the surgeon is observed as 4.83 ± 2.47 in group 1 and 6.5 ± 1.9 in group 2. Mesna applied patients were defined as significantly easier patients for the surgeon (P = 0.006).
Submucosal mesna application is an approach that provides a convenient, fast, and effective mucoperichondrial elevation in septoplasty and protects the mucosal integrity.
研究发现，名为美司钠的硫醇化合物经黏膜下注射可使结缔组织化学性软化，并有助于内镜黏膜下剥离术。作者旨在探讨美司钠注射在鼻中隔成形术中对黏骨膜抬高的影响。
本研究设计为病例对照研究并实施。56例行鼻中隔成形术的患者被分为两组，分别为黏膜下注射美司钠的患者（第1组）和黏膜下注射生理盐水的患者（第2组）。两组均在鼻中隔切开和抬高过程开始时启动计时器进行测量。双侧软骨膜下和骨膜下抬高完成后，停止计时并记录时间。之后，检查黏膜完整性并记录黏膜损伤情况。记录每位患者黏骨膜抬高对术者而言的难度。
参与本研究的患者中，25名（44.7%）为女性，31名（55.3%）为男性。第1组的平均抬高时间为201.4±74.3秒，第2组为260.2±84.1秒。在注射美司钠的患者中，抬高时间在统计学上显著更短（P = 0.009）。第1组黏膜完整性受损率为33.3%，第2组为58.8%。在注射美司钠的患者中，观察到黏膜完整性受损明显较少（P = 0.031）。术者对第1组黏骨膜抬高难度的平均评分为4.83±2.47，第2组为6.5±1.9。注射美司钠的患者对术者而言明显更容易操作（P = 0.006）。
黏膜下注射美司钠是一种在鼻中隔成形术中能提供便捷、快速且有效的黏骨膜抬高并保护黏膜完整性的方法。
