Department of Otorhinolaryngology, Selcuk University, Faculty of Medicine, Konya, Turkey.
Department of Otorhinolaryngology, Malatya Training and Research Hospital, Malatya, Turkey.
Am J Otolaryngol. 2021 Nov-Dec;42(6):103075. doi: 10.1016/j.amjoto.2021.103075. Epub 2021 Apr 21.
Halitosis, is a social problem affecting many patients seeking help from clinicians. Tonsil stones can cause halitosis and especially occur in crypts of palatine tonsils. Coblation cryptolysis is an alternative method for tonsil caseum treatment. The coblation technology includes passing a radiofrequency bipolar electrical current through a medium of normal saline which results in the production of a plasma field of sodium ions. In this study, our aim was to investigate the effectiveness of coblator cryptolysis treatment method in chronic caseous tonsillitis-induced halitosis.
We included in our study 28 patients who underwent coblator cryptolysis surgery for halitosis due to chronic caseous tonsillitis. The efficacy of treatment and the presence of caseoma were evaluated with the Finkelstein test, organoleptic test and VAS before the procedure and at the 6th month control after the treatment was completed.
At the 6th month follow-up after the procedure (a single coblation cryptolysis) we found that 23 of the patients (82.1%) had no caseum. There was a statistically significant change in Finkelstein measurements before and after the procedure (p < 0.001). Organoleptic measurements demonstrated that 21 patients had no halitosis postoperatively and the mean organoleptic test score was calculated as 0.39 ± 0.79 after the procedure. The recovery was statistically significant (p < 0.001). The mean VAS score before coblation cryptolysis was 8.0 ± 1.33 (range 5-10). On the other hand 6 months after a single coblation cryptolysis session, the mean VAS score was 1.25 ± 1.78 (range: 0-6). This difference was statistically significant (p < 0.001).
Our results suggest that coblation crptolysis is an effective, safe, minimally invasive and practical alternative method in treatment of halitosis due to tonsil caseums. We did not observe any complication after the procedure.
口臭是一种影响许多寻求临床医生帮助的患者的社会问题。扁桃体结石可引起口臭，特别是在腭扁桃体隐窝中发生。等离子体切除术是扁桃体结石治疗的替代方法。等离子体技术包括通过生理盐水传递双极射频电流，从而产生钠离子的等离子场。在这项研究中，我们的目的是研究等离子体切除术治疗方法对慢性扁桃体结石性扁桃体炎引起的口臭的疗效。
我们纳入了 28 例因慢性扁桃体结石性扁桃体炎引起口臭而行等离子体切除术的患者。在手术前和治疗完成后 6 个月的随访中，采用芬克尔斯坦试验、嗅觉试验和视觉模拟评分（VAS）评估治疗效果和结石的存在情况。
在手术后 6 个月的随访中（单次等离子体切除术），我们发现 23 例患者（82.1%）无结石。手术前后芬克尔斯坦测量值有统计学显著变化（p<0.001）。嗅觉测试显示，21 例患者术后无口臭，术后嗅觉测试平均得分为 0.39±0.79。恢复具有统计学意义（p<0.001）。在进行等离子体切除术之前，平均 VAS 评分为 8.0±1.33（范围 5-10）。另一方面，在单次等离子体切除术 6 个月后，平均 VAS 评分为 1.25±1.78（范围：0-6）。这一差异具有统计学意义（p<0.001）。
我们的结果表明，等离子体切除术是治疗扁桃体结石性口臭的一种有效、安全、微创和实用的替代方法。我们在手术后没有观察到任何并发症。
