Bidkar Vijay, Selvaraj Kalaiselvi, Raipure Amrusha, Dabhekar Sandeep, Prathipati Kiran Kumar, Sarode Lisha
Department of ENT, All India Institute of Medical Sciences, Nagpur, India.
Department of Community Medicine, All India Institute of Medical Sciences, Madurai, India.
J Rhinol. 2024 Nov;31(3):156-161. doi: 10.18787/jr.2024.00032. Epub 2024 Nov 30.
Flexible nasopharyngolaryngoscopy (F-NPLS) is a routine procedure performed in office settings. We compared two different intranasal scope navigation techniques used during F-NPLS, evaluating patient comfort and practitioner satisfaction.
This is a prospective, randomized, parallel-group controlled study. Patients undergoing F-NPLS to evaluate the upper airway were enrolled and randomized into two study groups. Patients in group A underwent intranasal scope negotiation following a trajectory below the middle turbinate; for group B, a trajectory along the inferior turbinate was used. The primary outcome evaluated was the successful, unhindered negotiation of the scope on the first attempt. Secondary outcomes included patient-perceived pain, incidents of mucosal trauma and bleeding, and the frequency and necessity of repeat scopy.
In total, 111 patients were randomized into group A (n=53) and group B (n=58). Baseline characteristics, such as age and sex, were similar in both groups. There was no statistically significant difference between the groups with respect to the primary outcome (group A: 52.8% vs. group B: 55.2%, p=0.8). The frequency of F-NPLS without episodes of mucosal trauma was significantly higher in group B (group A: 56.9% vs. group B: 35.9%, p=0.004). Mucosal ecchymosis was a common finding in group A (group A: 41.5% vs. group B: 13.8%, p=0.03), while nasal bleeding was more frequently observed in group B, although the difference was not statistically significant (group A: 29.3% vs. group B: 22.6%, p=0.42).
The present study demonstrated that the success rate of unhindered F-NPLS was comparable between the two trajectories. However, patients experienced moderate to severe pain during repeat scopy compared to the initial F-NPLS attempt.
可弯曲鼻咽喉镜检查（F-NPLS）是在门诊环境中进行的常规操作。我们比较了F-NPLS过程中使用的两种不同的鼻内镜导航技术，评估患者的舒适度和操作者的满意度。
这是一项前瞻性、随机、平行组对照研究。纳入接受F-NPLS以评估上呼吸道的患者，并随机分为两个研究组。A组患者在中鼻甲下方的轨迹进行鼻内镜操作；B组采用沿下鼻甲的轨迹。评估的主要结局是首次尝试时成功、无阻地完成内镜操作。次要结局包括患者感知的疼痛、黏膜创伤和出血事件，以及重复检查的频率和必要性。
总共111例患者被随机分为A组（n = 53）和B组（n = 58）。两组的基线特征，如年龄和性别，相似。两组在主要结局方面无统计学显著差异（A组：52.8% 对B组：55.2%，p = 0.8）。B组无黏膜创伤事件的F-NPLS频率显著更高（A组：56.9% 对B组：35.9%，p = 0.004）。黏膜瘀斑在A组是常见发现（A组：41.5% 对B组：13.8%，p = 0.03），而鼻出血在B组更频繁观察到，尽管差异无统计学意义（A组：29.3% 对B组：22.6%，p = 0.42）。
本研究表明，两种轨迹的无阻F-NPLS成功率相当。然而，与首次F-NPLS尝试相比，患者在重复检查时经历了中度至重度疼痛。
