Kim Hyung Gu, Kim Dong Su, Choi Yeon Sik, Lee Eun-Seol, Yoo Hye-Jin, Kim Dong-Young
Department of Otolaryngology-Head & Neck Surgery, Hanyang University Guri Hospital, Guri, Korea.
GTG Wellness Co. LTD, Seoul, Korea.
Clin Exp Otorhinolaryngol. 2023 May;16(2):141-147. doi: 10.21053/ceo.2022.01312. Epub 2023 Feb 13.
To compare the efficacy and safety of high-intensity focused ultrasound (HIFU) therapy with coblation for the treatment of inferior turbinate hypertrophy (ITH).
In this randomized controlled clinical trial, 20 patients underwent inferior turbinate surgery, which consisted of either HIFU or coblation therapy. Efficacy, safety, and tolerability were evaluated by subjective symptom scores, acoustic rhinometry, and nasal endoscopy.
The modified nasal obstruction symptom evaluation (NOSE) score and nasal obstruction visual analog scale (NO-VAS) significantly decreased in both groups 12 weeks postoperatively. The between-group differences in the evaluation scores were not statistically significant. On nasal endoscopy, the HIFU patients showed improvements in mucosal swelling sooner than the patients undergoing coblation therapy. Nasal crusting significantly increased in the patients undergoing coblation compared to the patients undergoing HIFU therapy until postoperative week 4. Mucosal preservation was superior in the HIFU patients. Although HIFU was less painful than coblation therapy during the procedure, the difference was not significant (4.9 vs. 6.3, P=0.143). The difference in global satisfaction between the two groups was not statistically significant, although satisfaction was slightly higher among the HIFU patients than among the coblation patients (4.6 vs. 4.1, P=0.393).
HIFU provided results similar to those of coblation therapy for patients with nasal obstruction due to ITH, but HIFU therapy caused less discomfort during the procedure. HIFU therapy appears to be a good noninvasive alternative to the current surgical modalities for ITH.
比较高强度聚焦超声(HIFU)治疗与低温等离子消融术治疗下鼻甲肥大(ITH)的疗效和安全性。
在这项随机对照临床试验中,20例患者接受了下鼻甲手术,手术方式为HIFU或低温等离子消融术。通过主观症状评分、鼻声反射测量和鼻内镜检查评估疗效、安全性和耐受性。
术后12周,两组患者改良鼻阻塞症状评估(NOSE)评分和鼻阻塞视觉模拟量表(NO-VAS)均显著降低。两组评估分数的组间差异无统计学意义。鼻内镜检查显示,HIFU治疗组患者黏膜肿胀的改善比低温等离子消融术治疗组患者更早。与HIFU治疗组患者相比,低温等离子消融术治疗组患者术后第4周前鼻痂明显增多。HIFU治疗组患者的黏膜保留情况更好。虽然HIFU治疗过程中的疼痛程度低于低温等离子消融术治疗,但差异不显著(4.9 vs. 6.3,P = 0.143)。两组患者的总体满意度差异无统计学意义,尽管HIFU治疗组患者的满意度略高于低温等离子消融术治疗组患者(4.6 vs. 4.1,P = 0.393)。
对于ITH引起鼻阻塞的患者,HIFU治疗的效果与低温等离子消融术相似,但HIFU治疗过程中引起的不适较少。HIFU治疗似乎是目前ITH手术方式的一种良好的非侵入性替代方法。