Stölzel Katharina, Bandelier Marie, Szczepek Agnieszka J, Olze Heidi, Dommerich Steffen
Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin, Campus Charité Mitte, Chariteplatz 1, 10117 Berlin, Germany.
Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin, Campus Charité Mitte, Chariteplatz 1, 10117 Berlin, Germany.
Am J Otolaryngol. 2017 Nov-Dec;38(6):668-672. doi: 10.1016/j.amjoto.2017.08.009. Epub 2017 Aug 30.
Chronic hyperplasia of the inferior nasal concha is accompanied by a nasal obstruction; however, there is no standardised surgical treatment for this condition. Here, we compared the outcome of three surgical techniques frequently used to treat the hyperplasia of inferior turbinates: turbinectomy with lateralization, submucosal electrocautery and laser cautery additional to septoplasty.
One hundred and nine patients participated in this prospective randomized study upon signing written consent. The subjects were randomly assigned to one of three intervention groups: 1) submucosal turbinectomy with lateralization, 2) submucosal electrocautery or 3) laser cautery. All groups were followed-up for up to 6months after surgical intervention. During the four follow-up appointments, the outcomes were measured with the modified German version of Sino-Nasal Outcome Test 20 questionnaire. In addition, the nasal breathing and the absolute nasal flow rates and respective mucosal component were determined by the anterior rhinomanometry.
Following surgery, the subjective and objective nasal obstruction decreased significantly in all three groups. Moreover, the subjective symptoms measured by modified Sino-Nasal Outcome Test 20 improved significantly, although there were some temporal differences between groups regarding subjective nasal obstruction, ear pressure, nasal discomfort, daytime fatigue, cough and dry mouth. The mucosal component of nasal congestion decreased significantly after surgery.
All surgical techniques used to reduce the conchae mucosa led to a significant improvement in the objective and subjective nasal breathing and the quality of life. Septoplastic reduction proved to be of additional benefit.
下鼻甲慢性增生伴有鼻塞；然而，对于这种情况尚无标准化的外科治疗方法。在此，我们比较了三种常用于治疗下鼻甲增生的手术技术的效果：下鼻甲外移切除术、黏膜下电灼术以及在鼻中隔成形术基础上加用激光烧灼术。
109名患者在签署书面同意书后参与了这项前瞻性随机研究。受试者被随机分配至三个干预组之一：1）黏膜下下鼻甲外移切除术，2）黏膜下电灼术，或3）激光烧灼术。所有组在手术干预后均随访长达6个月。在四次随访预约期间，使用改良的德文版《鼻-鼻窦结局测试20》问卷来测量结果。此外，通过前鼻测压法测定鼻呼吸、绝对鼻气流速率以及各自的黏膜成分。
手术后，所有三组的主观和客观鼻塞均显著减轻。此外，改良的《鼻-鼻窦结局测试20》所测量的主观症状有显著改善，尽管在主观鼻塞、耳压、鼻不适、日间疲劳、咳嗽和口干方面，各组之间存在一些时间差异。术后鼻充血的黏膜成分显著减少。
所有用于减少鼻甲黏膜的手术技术均使客观和主观鼻呼吸以及生活质量得到显著改善。鼻中隔成形术的复位被证明有额外益处。
