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微波消融治疗咽部良性病变的前瞻性初步病例系列研究。

Microwave ablation for the removal of pharyngeal benign lesions: A prospective pilot case series.

机构信息

Department of Otorhinolaryngology, Yiwu Hospital of Wenzhou Medical University (Yiwu Central Hospital), Yiwu City 322000, Zhejiang Province, China.

Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China.

出版信息

Am J Otolaryngol. 2021 May-Jun;42(3):102916. doi: 10.1016/j.amjoto.2021.102916. Epub 2021 Jan 13.

Abstract

OBJECTIVE

We evaluated microwave ablation (MWA) for treatment of isolated pharyngeal benign lesions, in terms of technical feasibility, efficacy, and safety.

METHODS

The patients with pharyngeal benign lesions were treated with endoscopic MWA with a 2450-MHz single cooled-shaft microwave antenna and sent for histological examination. Postoperative pain intensity was measured via visual analogue scale (VAS) on the 12th hour and the third postoperative days.

RESULTS

Of the 137 patients with pharyngeal benign lesions who met the inclusion criteria. The most commonly involved site was the uvula (n = 66, 48.2%), followed by the lateral pharyngeal wall (n = 37, 27.0%), the nasopharyngeal posterior wall (n = 23, 16.8%) and the soft palate (n = 11, 8.0%). All of the procedures were completed using local anesthesia and were well-tolerated by the patients. The ablation time was 5-10 min, with an average duration of 6.3 ± 1.8 min. The most common pathology was papilloma (n = 96, 70.1%), followed by nasopharyngeal cysts (n = 21, 15.3%), polyp (n = 10, 7.3%), epidermoid cysts (n = 8, 5.8%) and Thornwaldt cysts (n = 2, 1.5%). The mean VAS pain score was 2.36 ± 1.08 on postoperative 12th hour and 1.21 ± 0.54 on postoperative third day. At the 6-month follow-up examination, there were no severe complications, such as recurrence, bleeding, or synechiae of the nasal cavity, eustachian tube injury, in any of the patients.

CONCLUSIONS

The MWA for the treatment of isolated pharyngeal benign lesion is feasible and alternative to conventional surgical methods, it allows excision of the lesion while providing hemostasis, involves only a short ablation time and has a very low risk of complications. Most of our patients well-tolerate the procedure, which may be performed under local anesthesia in the outpatient setting.

摘要

目的

我们评估了内镜下微波消融(MWA)治疗孤立性咽良性病变的技术可行性、疗效和安全性。

方法

对符合纳入标准的 137 例咽良性病变患者,采用 2450MHz 单冷轴微波天线行内镜下 MWA 治疗,并进行组织学检查。术后第 12 小时和第 3 天通过视觉模拟量表(VAS)测量术后疼痛强度。

结果

137 例符合纳入标准的咽良性病变患者中,最常见的病变部位为悬雍垂(n=66,48.2%),其次为咽侧壁(n=37,27.0%)、鼻咽后壁(n=23,16.8%)和软腭(n=11,8.0%)。所有操作均在局部麻醉下完成,患者均能耐受。消融时间为 5-10min,平均 6.3±1.8min。最常见的病理类型为乳头状瘤(n=96,70.1%),其次为鼻咽囊肿(n=21,15.3%)、息肉(n=10,7.3%)、表皮样囊肿(n=8,5.8%)和 Thornwaldt 囊肿(n=2,1.5%)。术后第 12 小时 VAS 疼痛评分为 2.36±1.08,术后第 3 天 VAS 疼痛评分为 1.21±0.54。6 个月随访时,所有患者均无严重并发症,如复发、出血、鼻腔粘连、咽鼓管损伤等。

结论

MWA 治疗孤立性咽良性病变是可行的,可替代传统的手术方法,既能切除病变又能止血,消融时间短,并发症风险低。我们的大多数患者都能耐受该操作,该操作可在门诊局部麻醉下进行。

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