Torossian F, Giard A, Cereja F
Service ORL, Hôpital de Lavaur.
Presse Med. 1997 Oct 18;26(31):1482-7.
Heat emitted during the process of inflammation can be visualized by means of dynamic telethermography (DDT). In the case of sinusitis, it is possible to verify the efficacy of an anti-inflammatory treatment such as betamethasone.
Ten adult ambulatory patients with sinusitis were treated with 2 tablets of betamethasone (Celestene) 2 mg daily for 10 days without concomitant medications. DDT images were obtained on day 0, day 2, day 3, day 5 and day 10. A color chart indicated differences in temperature according to the selected sensitivity. Computer analysis of the images was then obtained. Clinical assessment of symptoms and tolerance were recorded at the same time-points as the DDt images.
The effect of treatment was beneficial in all patients since cure of sinusitis was achieved in 5, with marked improvement in 4 others and fair improvement in 1. Pain was significantly reduced on day 10 compared with day 0 (Friedman's test p < 0.0001). There was a simultaneous reduction of sinusitis associated signs: rhinorrhea, lacrimation, photophobia and cutaneous hyperesthesia as well as of general signs. On the DDT images, right-sinus to right-side and left-sinus to left-side ratios both showed a significant decrease between day 0 and day 10 from 41.00 +/- 14.07 to 7.90 +/- 7.22 (ANOVA p < 0.0001) and from 30.70 +/- 5.20 +/- 6.49 (ANOVA p < 0.0001) respectively.
Whereas in animal pharmacology inflammation can be evaluated by any number of objective methods, only a very few are applicable to clinical situations. Powerful computer image analysis may prove useful in establishing nature and severity based inflammation reduction standards.
These preliminary findings demonstrated that in most cases single agent therapy provides adequate and rapid control of clinical and thermographic signs of acute sinusitis. Computer analysis corraborates clinical findings and thermogram interpretations.
炎症过程中散发的热量可通过动态远红外热像仪（DDT）进行可视化观察。对于鼻窦炎患者，有可能验证诸如倍他米松等抗炎治疗的疗效。
10例成年门诊鼻窦炎患者，每日服用2片2mg的倍他米松（Celestene），持续10天，不使用其他伴随药物。在第0天、第2天、第3天、第5天和第10天获取DDT图像。根据所选灵敏度，彩色图表显示温度差异。然后对图像进行计算机分析。在与DDT图像相同的时间点记录症状和耐受性的临床评估。
所有患者的治疗均有益，5例患者鼻窦炎治愈，4例显著改善，1例有所改善。与第0天相比，第10天疼痛明显减轻（Friedman检验p < 0.0001）。鼻窦炎相关体征同时减轻：流涕、流泪、畏光和皮肤感觉过敏以及全身症状。在DDT图像上，右侧鼻窦与右侧、左侧鼻窦与左侧的比率在第0天和第10天之间均显著下降，分别从41.00±14.07降至7.90±7.22（方差分析p < 0.0001）和从30.70±5.20降至6.49（方差分析p < 0.0001）。
在动物药理学中，炎症可以通过多种客观方法进行评估，但只有极少数方法适用于临床情况。强大的计算机图像分析可能有助于建立基于炎症减轻的性质和严重程度的标准。
这些初步研究结果表明，在大多数情况下，单一药物治疗可充分且快速地控制急性鼻窦炎的临床和热像图体征。计算机分析证实了临床发现和热像图解读。
