Department of Otorhinolaryngology-Head and Neck Surgery, Istanbul Training and Research Hospital, Istanbul, Turkey.
Department of Pathology, Istanbul Training and Research Hospital, Istanbul, Turkey.
Acta Otorhinolaryngol Ital. 2021 Feb;41(1):51-58. doi: 10.14639/0392-100X-N0920.
To determine whether submucosal mesna (2-mercaptoethane sodium sulfonate) infiltration is superior to normal saline or adrenaline + lidocaine in mucoperichondrial hydrodissection.
Twenty-one rabbits were administered adrenaline + lidocaine, saline or mesna. Bilateral septal mucoperichondrial flap elevations were performed following submucosal infiltration. The intraoperative bleeding amount, operation time, accessibility of the surgical plane, field quality and degree of mucoperichondrial injury were recorded. The three groups were compared histopathologically.
The amount of bleeding and duration of the operation were significantly higher and the accessibility of the surgical plane score was significantly lower in the saline group vs. the other groups (p < 0.05). The mucosal damage rate was significantly higher in the saline group compared with adrenaline + lidocaine (p < 0.05). The surgical field quality was significantly lower in the saline group compared with adrenaline + lidocaine (p < 0.05). The accessibility of the correct surgical plane score was significantly lower in the saline group compared with the adrenaline + lidocaine and mesna groups (p < 0.05). The amount of bleeding, duration of operation, surgical field quality and accessibility of the surgical plane did not differ significantly between the adrenaline + lidocaine and mesna groups (p > 0.05). The pericondrium thickness was significantly lower in the saline group than the other groups. Cartilage thickness was significantly higher in the saline group compared with the mesna group (p > 0.05).
Use of mesna instead of normal saline or adrenaline + lidocaine in septoplasty was not more advantageous in terms of intraoperative parameters. The adrenaline + lidocaine group was superior to normal saline for all intraoperative parameters. In conclusion, the use of adrenaline may be more advantageous in facilitating septal mucoperichondrium elevation due to its widespread use, low cost and superiority to physiological saline.
比较黏膜下注射美司钠（2-巯基乙烷磺酸钠）与生理盐水或肾上腺素+利多卡因在黏膜下软骨膜分离中的效果。
21 只兔子被给予肾上腺素+利多卡因、生理盐水或美司钠。双侧鼻中隔黏膜下软骨膜瓣掀起后行黏膜下浸润。记录术中出血量、手术时间、手术平面的可达性、手术野质量和黏膜软骨膜损伤程度。对三组进行组织病理学比较。
与其他两组相比，生理盐水组的出血量和手术时间显著增加，手术平面可达性评分显著降低（p<0.05）。与肾上腺素+利多卡因组相比，生理盐水组的黏膜损伤率显著升高（p<0.05）。与肾上腺素+利多卡因组相比，生理盐水组的手术野质量显著降低（p<0.05）。与肾上腺素+利多卡因和美司钠组相比，生理盐水组的正确手术平面可达性评分显著降低（p<0.05）。肾上腺素+利多卡因和美司钠组之间的出血量、手术时间、手术野质量和手术平面可达性无显著差异（p>0.05）。生理盐水组的软骨膜厚度显著低于其他两组。与美司钠组相比，生理盐水组的软骨厚度显著升高（p>0.05）。
在鼻中隔成形术中，与生理盐水或肾上腺素+利多卡因相比，使用美司钠在术中参数方面并没有优势。肾上腺素+利多卡因组在所有术中参数方面均优于生理盐水组。总之，由于肾上腺素的广泛应用、成本低和优于生理盐水，因此在促进鼻中隔黏膜下软骨膜掀起方面可能更具优势。
