Hussain Raj Tajamul, Ahmad Rauf
Department of Otorhinolaryngology, Government Medical College, Srinagar, J&K India.
Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):826-834. doi: 10.1007/s12070-020-01876-z. Epub 2020 May 8.
The aim of this study was to evaluate the efficacy of CO laser ablation in the management of symptomatic hypertrophied inferior nasal turbinates. This prospective observational study was carried out on 53 patients with symptomatic ITH refractory to medical management in the Department of Otorhinolaryngology and Head and Neck Surgery, SMHS Hospital, Srinagar, J&K from January 2017 to June 2018 after obtaining ethical clearance. The pre and postoperative subjective assessment of the nasal obstruction included nasal obstruction symptom evaluation scale (NOSE) and the visual analogue scale (VAS). Lund and Kennedy endoscopic scoring was used to assess postoperative intranasal crusting and tissue healing. Postoperative pain was evaluated using VAS. All patients underwent CO laser spot ablation of hypertrophic inferior turbinates under local anesthesia in an outpatient setting. The patients were followed up at 2 weeks, 1 month and 3 months postoperatively. The VAS score for nasal obstruction improved from preop score of 6.05 (± 2.1) to 3.0 (± 1.01), 2.01 (± 0.90), 1.18 (± 0.40) at 2 weeks, 1 month and 3 months respectively in the postop period and the NOSE score also improved from preop score of 64.90 (± 13.29) to post-operative NOSE score of 18.96 (± 9.53) at 2 weeks, 9.81 (± 7.33) at 1 month and 5.09 (± 4.28) at 3 months. Difference between preoperative and postoperative NOSE and VAS scores was statistically significant (< 0.05). There was minimal postoperative pain and intranasal crusting. Postoperative tissue healing was also good. CO laser turbinoplasty is a safe and effective way of improving nasal flow. It offers more precision, gentleness, control and less intraoperative discomfort. CO laser turbinoplasty meets all of the criteria for an ideal method for the treatment of nasal obstruction secondary to inferior turbinate hypertrophy with improvement of quality of life and reducing the risk of medical morbidity.
本研究的目的是评估CO激光消融术治疗症状性下鼻甲肥大的疗效。本前瞻性观察性研究于2017年1月至2018年6月在查谟和克什米尔斯利那加SMHS医院耳鼻咽喉头颈外科对53例经药物治疗无效的症状性下鼻甲肥大患者进行，研究获得伦理批准后开展。鼻阻塞的术前和术后主观评估包括鼻阻塞症状评估量表（NOSE）和视觉模拟量表（VAS）。采用Lund和Kennedy内镜评分评估术后鼻内结痂和组织愈合情况。使用VAS评估术后疼痛。所有患者在门诊局部麻醉下接受CO激光点状消融肥大的下鼻甲。术后2周、1个月和3个月对患者进行随访。术后，鼻阻塞的VAS评分分别从术前的6.05（±2.1）改善至术后2周的3.0（±1.01）、1个月的2.01（±0.90）、3个月的1.18（±0.40），NOSE评分也从术前的64.90（±13.29）改善至术后2周的18.96（±9.53）、1个月的9.81（±7.33）、3个月的5.09（±4.28）。术前和术后NOSE及VAS评分之间的差异具有统计学意义（<0.05）。术后疼痛和鼻内结痂轻微。术后组织愈合也良好。CO激光鼻甲成形术是改善鼻通气的一种安全有效的方法。它具有更高的精确性、更温和、可控性更强以及术中不适更少等优点。CO激光鼻甲成形术符合治疗下鼻甲肥大继发鼻阻塞的理想方法的所有标准，可改善生活质量并降低医疗并发症风险。
