- 期刊
以射頻縮減下鼻甲組織體積治療慢性鼻塞
Radiofrequency Volumetric Tissue Reduction of the Inferior Turbinates for the Treatment of Chronic Nasal Obstruction
摘要
背景：治療下鼻甲肥厚所引起的慢性鼻塞其手術方式有許多種，藉由溫度的監控利用射頻（temperature-controlled radiofrequency, TCRF）所產生的熱能來施行手術，則有傳統黏膜下鼻甲切除及雷射下鼻甲手術所不及的優點。本研究利用射頻藉由探針作用於同側下鼻甲前上部及前下部，並提供較高的治療總能量，評估治療成效、安全性、舒適性及病人滿意度。 方法：自2000年3月至同年7月期間，收集在本部接受下鼻甲射頻組織體積縮減手術治療慢性鼻塞且完成研究評估者共計50名。在術前及術後以問卷、局部理學檢查、鼻阻力檢查來估，並將病人術後的症狀以visual analogue scales （VAS）的方式加以統計分析。 結果：術後門診追蹤並未發現有明顯出血、結痂、傷口感染及黏連情形；32%病人術後有短暫的傷口腫脹及鼻塞加重，但皆於術後24~72小時緩解。術中及術後病患多不感覺疼痛。術後追蹤16週，有96%病患鼻塞改善，滿意度平均可達86.8%，而手術後1年內鼻塞仍持續獲得改善佔72%。 結論：以射頻組織體積縮減手術治療因下鼻甲肥厚所引起的慢性鼻塞效果良好。相對於傳統黏膜下鼻甲切除及雷射下鼻甲手術，有以下優點：1）可以保持鼻甲黏膜表面的完整性，因此不易產生痂皮及黏連，2）術中及術後出血危險性相對較小，故不需鼻填塞，3）可以門診手術方式施行，手術過程迅速，病人不覺痛苦而接受度高。
並列摘要
BACKGROUND: A variety of surgical procedures are used for the treatment of chronic nasal obstruction caused by hypertrophic inferior turbinates. Radiofrequency tissue volumetric reduction (RFTVR) of the inferior turbinates has advantages over traditional submucosal resection and laser surgery. A prospective evaluation was performed investigating the safety, efficacy, and satisfaction of RFTVR for the treatment of chronic nasal obstruction that delivered higher energies and created two thermal lesions per turbinate. METHODS: Fifty patients with symptoms of chronic nasal obstruction caused by hypertrophic inferior turinates were included in the study and underwent radiofrequency tissue volumetric reduction of the inferior turbinates in our ENT department between March and July 2000. Visual analogue scales were used to assess the pain of the treatment, and the degree and frequency of nasal obstruction. All patients were examined to asses bleeding, crusting, synechia formation, swelling blockage, dryness and other side effects following treatment. RESULT: No evidence of bleeding, synechia formation and infection was documented at each follow-up session up to 16 weeks. Postoperative swelling blockage was noted in 32% of the patients and resolved within 24 to 72 hours. Sixteen weeks after treatment, nasal obstruction improved in 96% of the patients, and patient satisfaction was an average of 86.8%. Improvements in nasal obstruction persisted in 72% of the patients one year postoperatively. CONCLUSION: Radiofrequency tissue volumetric reduction is safe and effective in improving chronic nasal obstruction secondary to inferior turbinate hypertrophy. In contrast with traditional submucosal resection or laser techniques, complications such as bleeding, synechia formation, crusting and postoperative pain are rare.