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下鼻甲手术对耳部症状的影响。

The effect of inferior turbinate surgery on ear symptoms.

作者信息

Harju Teemu, Kivekäs Ilkka, Numminen Jura, Rautiainen Markus

机构信息

Department of Otorhinolaryngology, Tampere University Hospital, Tampere, Finland.

出版信息

Laryngoscope. 2018 Mar;128(3):568-572. doi: 10.1002/lary.26823. Epub 2017 Aug 22.

Abstract

OBJECTIVE

The aim of this placebo-controlled study was to evaluate the effect of various inferior turbinate surgery techniques on Eustachian tube dysfunction-related symptoms.

STUDY DESIGN

Outcomes were evaluated using the Eustachian Tube Dysfunction Questionnaire (ETDQ-7) and tympanometry results.

METHODS

A total of 72 consecutively blinded and randomized adult patients with enlarged inferior turbinates due to persistent year-round rhinitis underwent either a radiofrequency ablation, diode laser, microdebrider-assisted inferior turbinoplasty, or sham surgery procedure. Assessments were conducted prior to surgery and 3 months subsequent to the surgery.

RESULTS

In the evaluation of all patients, radiofrequency ablation, microdebrider-assisted inferior turbinoplasty, and sham surgery procedures decreased the ETDQ-7 total score significantly. In a three-way analysis of covariance, there were no significant differences in the results between sham surgery and any of the active treatment procedures. Allergic sensitization, sex, and age also had no effect on the results. There were no significant changes in the pre- and postoperative amounts of abnormal tympanometry curves or in the pre- and postoperative tympanometric peak pressure values in the actively treated patients or in the sham surgery group.

CONCLUSION

The improvement of Eustachian tube dysfunction-related symptoms due to surgery of the anterior half of the inferior turbinate was found to be equal to placebo. The findings of this study do not support the use of reduction of the anterior half of the inferior turbinate as a sole procedure intended to treat the ear symptoms assessed by the ETDQ-7 questionnaire.

LEVEL OF EVIDENCE

1b. Laryngoscope, 128:568-572, 2018.

摘要

目的

这项安慰剂对照研究的目的是评估各种下鼻甲手术技术对咽鼓管功能障碍相关症状的影响。

研究设计

使用咽鼓管功能障碍问卷(ETDQ-7)和鼓室导抗图结果评估结局。

方法

共有72例因常年性持续性鼻炎导致下鼻甲肿大的成年患者,连续接受盲法随机分组,分别接受射频消融、二极管激光、微型切割器辅助下鼻甲成形术或假手术。在手术前和手术后3个月进行评估。

结果

在对所有患者的评估中,射频消融、微型切割器辅助下鼻甲成形术和假手术均显著降低了ETDQ-7总分。在三因素协方差分析中,假手术与任何一种积极治疗方法的结果之间均无显著差异。过敏致敏、性别和年龄对结果也无影响。积极治疗组患者或假手术组患者术前和术后鼓室导抗图异常曲线数量及术前和术后鼓室导抗图峰值压力值均无显著变化。

结论

发现下鼻甲前半部分手术导致的咽鼓管功能障碍相关症状的改善与安慰剂相当。本研究结果不支持将下鼻甲前半部分缩小作为旨在治疗ETDQ-7问卷评估的耳部症状的唯一手术方法。

证据水平

1b。《喉镜》,2018年,第128卷,第568 - 572页。

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