Manimaran Vinoth, Babu Divya Macherla, Lakshmanan Somu, Palanisamy Thirunavukarasu
Department of Otolaryngology and Head and neck surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, India.
Indian J Otolaryngol Head Neck Surg. 2023 Apr;75(Suppl 1):973-977. doi: 10.1007/s12070-023-03491-0. Epub 2023 Feb 10.
To assess the efficacy of submucosal diathermy (SMD) in Chronic rhinosinusitis and inferior turbinate hypertrophy undergoing Functional Endoscopic Sinus Surgery.
We conducted a Randomized Prospective study in patients undergoing Functional Endoscopic Sinus surgery for Chronic Rhinosinusitis in a tertiary care centre in South India for a period of 2 years. Patients were divided into two groups, Group A underwent FESS and Group B underwent FESS with SMD. The outcome was evaluated using nasal endoscopy score (NES), modified SNOT score and Modified Lund Kennedy scores.
A total of 80 patients were included in this study.40 patients were allotted in each group. Male: Female ratio was 48:32. The age distribution ranged from 19 to 44 years with a mean of 29.55 ± 6.90 yrs. Mean NES scores, Modified SNOT and Modified Lund -kennedy scores were estimated pre-operatively and during 1st, 2nd and 3rd month of post-operative periods. The mean pre-operative sores were comparable in both the groups except NES score, which was higher in group B. Both the groups showed significant improvement in post-operative period. Inter group comparison showed significant difference in all scores with group B having better results when compared to group A.
This study proves that FESS combined with SMD improves the postoperative clinical outcomes when compared with FESS without turbinate reduction. We conclude that SMD is a simple, mucosal preserving technique with almost no complications and can be safely done along with FESS to improve the outcomes .
评估黏膜下透热疗法(SMD)在慢性鼻窦炎及下鼻甲肥大患者接受功能性鼻内镜鼻窦手术中的疗效。
我们在印度南部一家三级护理中心对接受功能性鼻内镜鼻窦手术治疗慢性鼻窦炎的患者进行了一项为期2年的随机前瞻性研究。患者分为两组,A组接受功能性鼻内镜鼻窦手术(FESS),B组接受FESS联合SMD。使用鼻内镜评分(NES)、改良鼻窦症状测试(SNOT)评分和改良Lund - Kennedy评分评估结果。
本研究共纳入80例患者,每组40例。男女比例为48:32。年龄分布在19至44岁之间,平均年龄为29.55 ± 6.90岁。术前及术后第1、2、3个月评估平均NES评分、改良SNOT评分和改良Lund - Kennedy评分。除NES评分外,两组术前平均评分相当,B组的NES评分更高。两组术后均有显著改善。组间比较显示,所有评分均有显著差异,B组结果优于A组。
本研究证明,与未行鼻甲缩小的FESS相比,FESS联合SMD可改善术后临床效果。我们得出结论,SMD是一种简单的、保留黏膜的技术,几乎无并发症,可与FESS安全联合进行以改善治疗效果。