Manzala General Hospital, Al Manzalah, 35511, Dakahlia, Egypt.
Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Eur Arch Otorhinolaryngol. 2021 Oct;278(10):3827-3837. doi: 10.1007/s00405-021-06663-2. Epub 2021 Feb 13.
The aim of this study was to compare the outcome of submucous resection and combined submucous diathermy with outfracture technique in treatment of nasal obstruction caused by inferior turbinate hypertrophy.
This study is a prospective randomized clinical trial involving 90 patients with hypertrophied inferior turbinate not responding to medical treatment. All patients were selected with equal or near equal mucosal and bony turbinate components using computed tomography (CT) and then randomly allocated into two groups; group A (n = 45): underwent submucous resection in both sides and group B (n = 45): underwent combined submucous diathermy and outfracture in both sides. Subjective (NOSE score) and objective (4-grades endoscopic classification system and PNIF evaluation) measures of nasal airflow were done preoperatively and postoperatively.
Subjective assessment using NOSE scale proved that both techniques were effective in relieving nasal obstruction as it improved in both groups postoperatively compared to the preoperative data. However, resection technique was better than diathermy technique with a statistically significant difference (p < 0.05), while objective assessment of nasal obstruction showed better results in resection group than diathermy group, but with no statistically significant difference.
Both techniques are effective in relief of nasal obstruction due to inferior turbinate hypertrophy. However, submucous resection showed marked improvement compared to diathermy technique especially at long-term follow-up.
本研究旨在比较下鼻甲黏膜下切除术和联合黏膜下电凝与无骨折技术治疗下鼻甲肥大引起的鼻塞的疗效。
这是一项前瞻性随机临床试验,纳入 90 例对药物治疗无反应的下鼻甲肥大患者。所有患者均采用计算机断层扫描(CT)检查,根据鼻甲黏膜和骨质成分相等或相近的原则,将患者随机分为两组;A 组(n=45):行双侧下鼻甲黏膜下切除术;B 组(n=45):行双侧下鼻甲黏膜下电凝联合外移术。术前和术后分别采用主观(NOSE 评分)和客观(4 级内镜分类系统和 PNIF 评估)测量鼻气流。
NOSE 量表的主观评估表明,两种技术都能有效缓解鼻塞,与术前相比,术后两组患者的鼻塞均得到改善。然而,与电凝技术相比,切除术的效果更好,差异具有统计学意义(p<0.05);而客观评估下鼻甲肥大患者的鼻塞情况,发现切除术组的结果优于电凝组,但差异无统计学意义。
两种技术均可有效缓解下鼻甲肥大引起的鼻塞。然而,与电凝技术相比,下鼻甲黏膜下切除术的改善更为显著,尤其是在长期随访中。