Bahgat Ahmed Yassin
Department of Otorhinolaryngology, Alexandria University, Alexandria, Egypt.
OTO Open. 2021 Feb 2;5(1):2473974X21989599. doi: 10.1177/2473974X21989599. eCollection 2021 Jan-Mar.
Plasma is formed by creating a high-density energy field within an electrically conductive fluid such as saline. Sometimes ablated bits of tissue get stuck between the electrodes of the wand, obstructing the suction channel. The purpose of this study is to investigate the effect of cooling the irrigating saline during ablation of the hypertrophied tongue base in patients with obstructive sleep apnea.
Prospective randomized controlled trial.
An otorhinolaryngology department in Main University hospitals.
Sixty adult patients with obstructive sleep apnea and tongue base hypertrophy underwent tongue base ablation surgery. Patients were randomly divided into 2 groups of 30 patients each: cooled saline and room temperature saline. The Coblation wand used was the EVac 70 Xtra HP (Smith & Nephew).
In this study, a significant difference in operative time (mean ± SD) was seen between groups: 21.2 ± 5.5 minutes in the cold group and 47 ± 9.5 minutes in the control group ( = .001). The wands in the cold group did not obstruct, while all the wands in the control group were obstructed by tissue clogs with variable degrees, hence wasting more time to clean the wands' tips.
Cooling the irrigating saline overcame the problem of wand clogs, and the wand tip did not occlude at all during the procedures, thus saving time lost in wand cleaning and demonstrating a faster and safer surgical procedure. Further studies are needed to identify the hemostatic effect of the cooled saline over the regular one.
通过在诸如盐水等导电流体中创建高密度能量场来形成等离子体。有时，消融的组织碎片会卡在棒状电极之间，阻塞抽吸通道。本研究的目的是调查在阻塞性睡眠呼吸暂停患者的肥厚舌根消融过程中冷却冲洗盐水的效果。
前瞻性随机对照试验。
主要大学医院的耳鼻喉科。
60例患有阻塞性睡眠呼吸暂停和舌根肥大的成年患者接受了舌根消融手术。患者被随机分为两组，每组30例：冷却盐水组和室温盐水组。使用的Coblation棒是EVac 70 Xtra HP（施乐辉公司）。
在本研究中，两组之间的手术时间（平均值±标准差）存在显著差异：冷盐水组为21.2±5.5分钟，对照组为47±9.5分钟（P = 0.001）。冷盐水组的棒未发生阻塞，而对照组的所有棒均不同程度地被组织堵塞所阻碍，因此浪费了更多时间来清洁棒的尖端。
冷却冲洗盐水克服了棒堵塞的问题，并且在手术过程中棒尖端完全没有堵塞，从而节省了清洁棒所浪费的时间，并证明了手术过程更快、更安全。需要进一步研究以确定冷却盐水与常规盐水相比的止血效果。
