微創性黏膜下鼻甲整形術－初報

Mini-invasive Submucosal Turbinoplasty: A Preliminary Report

陳穆寬(Mu-Kuan Chen) ； 張正權(Cheng-Chuan Chang) ； 蘇金泉(Ching-Chuan Su)

《The Changhua Journal of Medicine》 8卷2期 (2003/04) Pp. 71-75

摘要

背景：慢性肥厚性鼻炎是導致鼻塞的一個重要因素。對於長期鼻塞且藥物治療無效的病人，以手術來減少下鼻甲體積是有效而可行的方法之一。本研究提出一種嘗試性的微創性黏膜下鼻甲整形術；即使用動力式Micro-debrider，漸進性精準地減少下鼻甲體積且完整地保留其全部黏膜。並評估：(1)此種手術對於治療鼻塞的效果，(2)病人術中疼痛程度，(3)手術併發症。
方法：自2001年2月至2001年7月，共有18位因慢性肥厚性鼻炎患者接受此項手術。手術時皆採局部麻醉，術後並不需鼻部填塞，亦不需住院。並以術後返診及電話問卷追蹤方式，針對疼痛程度、手術出血量、術後流血、手術併發症及鼻塞改善情形加以探討。
結果：術中與術後出血量極少，僅有一人(6.6%)其疼痛指數為中度，其餘多為不疼痛或輕微疼痛(93.7%),鼻塞方面有80%（短期追蹤）獲得改善，無任何手術併發症發生。
結論：相較於傳統上的各種方法，微創性鼻甲整形術的優點包括精準的減少下鼻甲體積以減少鼻塞之症狀、保留全部的下鼻甲黏膜、傷口小、不需鼻部填塞、不需住院、術中疼痛指數低、出血量極少以及恢復時間短等。因此對於肥厚性鼻炎的病人，微創性下鼻甲整形手術是值得採用的手術方法之一。

關鍵字

慢性肥厚性鼻炎 ； 微創性 ； 黏膜下鼻甲整形術

並列摘要

Background and purpose: Chronic hypertrophic rhinitis is an important component causing nasal obstruction. Patients with hypertrophic turbinates often benefit from turbinate reduction when medical treatment fails. Using the microdebrider, we developed a new technique of mini-invasive submucosal turbinoplasty to reduce the volume of the inferior turbinate. The aim of this study was to investigate the successful rate of this new surgical technique, intra-operative pain, and complications associated with the operation.
Methods: A prospective study was performed involving 18 patients with chronic hypertrophic rhinitis who were underwent surgery between February 2001 and July 2001. All patients underwent surgery under local anesthesia. After the operation, no nasal packing or hospitalization was necessary. The intra-operative pain scale, post-operative hemorrhage, and nasal obstruction were investigated.
Results: Intra-operative and post-operative bleeding was minimal. Only one patient had an operation pain scale above moderate, and the other pateints (93.7%) felt either no discomfort or mild discomfort. The overall success rate of this new technique was 80% in terms of nasal obstruction. No complications occurred.
Conclusions: Compared with several conventional techniques, the advantages of mini-invasive submucosal turbinoplasty include accurate reduction of the volume of the inferior turbinate, preservation of the mucosa of the turbinate, a small wound, a low pain scale, minimal intra-operative or post-operative bleeding, no need for nasal packing, surgery on an out-patient basis, and a shorter recovery time. Therefore, mini-invasive submucosal turbinoplasty is one of the best methods when surgery for patients with chronic hypertrophic rhinitis is considered.

並列關鍵字

chronic hypertrophy rhinitis ； mini-invasive ； submucosal turbinoplasty