Aroor Rajeshwary, Sunu Ali Zainab, Gangadhara Somayaji K S
Department of ENT, K S Hegde Medical Academy, Nitte University, Mangalore, India.
Department of ENT, Kanachur Institute of Medical Sciences, University Road, Derlakatte, Mangalore, 575018 India.
Indian J Otolaryngol Head Neck Surg. 2017 Mar;69(1):24-28. doi: 10.1007/s12070-016-1016-y. Epub 2016 Aug 18.
The study was conducted to assess the impact of different nasal surgeries on the nasal mucociliary clearance mechanism. Mucociliary function of the nasal mucosa of patients who were undergoing various nasal surgeries was assessed by the Saccharin test by placing 5 mg saccharin granule on the anterior end of the inferior turbinate 1 day prior to the surgery. The time required for the test subject to experience a sweet taste was measured in minutes. Post-operatively the test was repeated 6 weeks after the surgery and the test times were compared. A total of 60 patients were part of this study. Of the 60 cases, 19 cases had undergone only septoplasty, 13 cases had undergone only functional endoscopic sinus surgery (FESS), 25 cases had undergone septoplasty with FESS, 2 cases underwent septoplasty with bilateral partial inferior turbinectomy (PIT) and one case was submucous resection (SMR). Significant improvement in nasal mucociliary clearance was observed in all the patients after the procedures. Out of the 19 cases of septoplasty, 57.9 % showed improvement on the right side and 47.4 % on the left side. Out of the 13 cases of FESS, 61.5 % showed improvement on the right side and 69.2 % on the left side. Out of the 25 cases of FESS with septoplasty, 76.0 % showed improvement on both sides. The case of SMR did not show improvement. The 2 cases of septoplasty with PIT showed improvement. Statistically, highly significant improvement of test time was seen postoperatively as compared to pre-operatively. Among the surgical procedures, FESS with septoplasty showed better improvement as compared to the other procedures. Based on the study, we can conclude that nasal surgeries done for correction of septal deviation and rhino sinusitis significantly improves nasal mucociliary clearance mechanism thereby improving the physiological functions of the upper airway.
本研究旨在评估不同鼻腔手术对鼻黏膜纤毛清除机制的影响。通过糖精试验评估接受各种鼻腔手术患者鼻黏膜的纤毛功能，即在手术前1天将5毫克糖精颗粒置于下鼻甲前端进行检测。记录受试者尝到甜味所需的时间（以分钟计）。术后6周重复该测试，并比较测试时间。本研究共纳入60例患者。其中，19例仅接受鼻中隔成形术，13例仅接受功能性鼻内镜鼻窦手术（FESS），25例接受鼻中隔成形术联合FESS，2例接受鼻中隔成形术联合双侧部分下鼻甲切除术（PIT），1例接受黏膜下切除术（SMR）。所有患者术后鼻黏膜纤毛清除功能均有显著改善。在19例鼻中隔成形术患者中，右侧改善率为57.9%，左侧为47.4%。在13例FESS患者中，右侧改善率为61.5%，左侧为69.2%。在25例鼻中隔成形术联合FESS患者中，双侧改善率为76.0%。SMR病例未显示改善。2例鼻中隔成形术联合PIT患者显示改善。统计学分析显示，与术前相比，术后测试时间有高度显著改善。在所有手术方式中，鼻中隔成形术联合FESS的改善效果优于其他手术方式。基于本研究，我们可以得出结论，针对鼻中隔偏曲和鼻窦炎进行的鼻腔手术可显著改善鼻黏膜纤毛清除机制，从而改善上呼吸道的生理功能。
