等离子低温射频治疗舌根淋巴组织增生

我科自2002年3月～11月采用等离子低温射频(radiofrequency ablation，RFA)治疗舌根淋巴组织增生12例，取得满意疗效，现报告如下。     

鼻内镜下低温等离子射频治疗咽囊炎56例

近2年,我院采用鼻内镜下低温等离子射频治疗咽囊炎患者56例,治疗方法简单、彻底,效果良好,报告如下。1资料与方法1.1临床资料咽囊炎患者56例,男39例,女17例;年龄4～49岁。其中儿童47例,成人9例。主要症状为鼻后部流脓及枕部持续性疼痛,患者常感咽部有黏脓向下流至口咽部,有臭味     

鼻内镜下低温等离子射频治疗咽囊炎的临床应用

目的探讨鼻内镜下低温等离子射频治疗咽囊炎的疗效,并观察术后创面的变化。方法鼻内镜下低温等离子射频治疗咽囊炎12例、咽囊囊肿9例。术后第2天起用生理盐水冲洗鼻腔、鼻咽,每周鼻内镜下观察创面的变化,并记录白膜脱落的时间。结果治愈18例,有效3例。术后创面白膜在1～2周内脱落。结论鼻内镜检查有助于咽囊炎的诊断。鼻内镜下低温等离子射频治疗咽囊炎,术后用生理盐水冲洗鼻腔、鼻咽,疗效较好、创伤小。     

低温等离子射频治疗OSAHS 31例分析

低温等离子射频 (Temperature controlledradiofrequencyablation ,RFA)应用于打鼾和阻塞性睡眠呼吸暂停低通气综合症 (Obstructivesleepapnea hypopneasyndrome ,OSAHS)时间虽然不长 ,但是已显示了准确、便捷、有效、安全等优越性。像其他疗法一样RFA不能替代所有方法。RFA治疗OSAHS的疗效各家报道不尽相同。我科于 2 0 0 2年 4月～ 2 0 0 2年 9月选择部分病例采用RAF治疗 3 1例 ,现就本组病例按呼吸紊乱指数 (apnea hypopneaindex ,AHI)、最低血氧饱和度SaO2 、年龄、阻塞平面、及组织类型分组分别对照分析 ,以探索RFA治疗的…     

射频治疗舌根扁桃体肥大及咽后壁淋巴滤泡增生

我们应用射频技术治疗舌根扁桃体肥大及咽后壁淋巴滤泡增生症16例，疗效满意，报告如下。     

声带淋巴组织增生1例

患者,女,50岁,因咽部异物感,声音嘶哑3个月就诊。检查见咽部黏膜慢性充血,扁桃体Ⅰ度大,表面无充血。喉内镜下见双侧声带无充血,右侧声带前中1/3表面近边缘处有灰白色颗粒样小米粒大小新生物,左侧声带表面光滑,双侧声带运动好,会厌、杓区、梨状窝未见异常。表面麻醉纤维喉镜下行右侧声带肿物切除术,将肿物完整切除,病理报告为淋巴组织增生,并见碳末沉着（图1）。     

悬雍垂腭咽成形术加低温等离子射频消融的临床疗效分析

重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者,往往有多个阻塞平面同时存在,目前治疗有CPAP、UPPP及低温等离子射频治疗(RFA)等多种方法,以往我们对不能接受CPAP治疗的患者仅采用改良UPPP手术,虽获得了无食物鼻反流、开放性鼻音等并发症的效果,但术后远期疗效仍不理想。近几年,我科采用改良UPPP加RFA等综合治疗方法,明显提高了疗效,现报告如下。     

等离子低温射频消融治疗鼻塞疗效评价

目的评价等离子低温射频治疗下鼻甲肥厚的主观远期疗效。方法采用前瞻性非随机研究,均为门诊患者。美国Afthrocare等离子低温射频手术系统行下鼻甲消融,VAS评分法评价治疗前后鼻塞程度,t检验分析治疗前,治疗后2个月,治疗后1年疗效差异。结果治疗前后VAS统计学差异显著,1年后满意率100％,1次治疗满意率95％,除1例感染外,无其他并发症。结论等离子低温射频是目前下鼻甲肥大消融治疗的微创、安全、有效的方法。     

低温等离子射频消融对UPPP失败的补救性治疗

UPPP是治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的主要手术方法,其有效率长期徘徊在50%～60%左右[1],近年来认为多咽平面狭窄是影响其疗效的主要原因[2].笔者自2003年以来应用低温等离子射频消融技术对56例行UPPP治疗失败的OSAHS患者做补救性治疗,取得满意疗效,现报告如下.     

低温等离子射频治疗阻塞性睡眠呼吸暂停低通气综合征

阻塞性睡眠呼吸暂停低通气综合征（OSAHS）是一种睡眠期疾病，严重影响患者的生活质量和身体健康，且越来越受到人们的重视。近20年来悬雍垂腭咽成形术（UPPP）已广泛运用于临床，其疗效已获公认。但因其可带来各种并发症，甚至术中、术后发生窒息死亡，近几年低温等离子射频治疗OSAHS开始运用于临床，并取得了一定的疗效。我们从2003年开展低温等离子射频治疗OSAHS取得了较为满意的疗效，现报道如下。     

射频消融治疗下鼻甲肥厚所致鼻塞的疗效

目的 :探讨射频消融治疗下鼻甲肥厚所致鼻塞的效果。方法 :对 18例下鼻甲肥大致鼻塞患者采用射频消融术缩小双侧下鼻甲 ,术前及术后 3个月应用视觉模拟评分表 (VAS)来评价鼻塞的主观感觉。结果 :患者术前鼻塞VAS评分左侧为 (6 7.7± 9.4 ) % ,右侧为 (70 .5± 10 .5 ) % ;术后 3个月左侧为 (4 5 .0± 9.0 ) % ,右侧为(5 3.3± 11.6 ) % ,左右侧分别与术前比较 ,差异均有极显著性意义 (均P <0 .0 1)。随访 3个月 ,检查双侧下鼻甲与鼻中隔的最小距离从术前小于 0 .2cm增加到术后大于 0 .3cm。结论 :射频消融术是安全、有效、微创地治疗下鼻甲肥大所致鼻塞的较好治疗方法     

咽淋巴环非何杰金淋巴瘤(附37例临床分析)

目的探讨咽淋巴环非何杰金淋巴瘤的临床特征、误诊的原因和避免误诊的措施.方法回顾性分析37例咽淋巴环非何杰金淋巴瘤的临床资料.结果37例临床表现缺乏特征性,初次临床误诊有慢性扁桃体炎10例,扁桃体癌3例,鼻咽纤维血管瘤2例,鼻咽癌5例,舌根癌1例.初次常规病理检查误诊为慢性炎症4例,未分化癌2例.结论咽淋巴环非何杰金淋巴瘤无特异性临床表现,容易发生误诊,应提高对本病认识.扁桃体病灶的切除有助于扁桃体恶性淋巴瘤的诊治.     

Radiofrequency energy tissue ablation for the treatment of nasal obstruction secondary to turbinate hypertrophy.

OBJECTIVE/HYPOTHESIS: We hypothesized that the success rate of radiofrequency energy (RFe) tissue ablation of the inferior turbinate for nasal obstruction achieved by previous investigators would be improved by using a longer needle electrode and creating two lesions per turbinate. METHODS: Ten patients with nasal obstruction secondary to inferior turbinate hypertrophy were prospectively enrolled. A 40-mm needle delivered RFe to two sites in each inferior turbinate. Patients used a visual analog scale (VAS) to grade nasal obstruction preoperatively and at 1 week and 8 weeks after surgery. Preoperative and postoperative digital images of the nasal cavity were graded for obstruction (0% to 100%) in a blinded manner. RESULTS: All patients (100%) were subjectively improved at 8 weeks. Mean obstruction (VAS) improved from 50%+/-21% to 16%+/-15% (right side) and from 53%+/-29% to 13%+/-13% (left side). Mean improvements were 68% (right side) (P = .004) and 75% (left side) (P = .001). Mean obstruction graded during blinded review of nasal cavity images improved from 73.5%+/-8% to 51%+/-8% (right side) and from 76%+/-6% to 64%+/-7% (left side). Of nine patients using medications for nasal obstruction before treatment, eight (89%) noted no further need for medications at 8 weeks. CONCLUSION: The use of RFe for submucosal tissue ablation in the hypertrophied inferior turbinate is an effective modality for reducing symptoms of nasal obstruction. Improved results may occur by using a longer needle and creating two lesions per turbinate. Of patients in this study, 100% reported improvement of nasal obstruction.     

等离子低温射频消融在二次腺样体手术中的应用

目的:探讨应用等离子低温射频消融系统,切除经传统腺样体刮除术后复发的腺样体的临床疗效和意义。方法:应用等离子低温射频消融系统,结合间接喉镜直视下切除残留或复发腺样体50例。结果:术后随访≥2年,患儿打鼾明显减弱或消失,听力明显改善。结论:应用等离子低温射频消融系统,结合间接喉镜直视下切除经传统腺样体刮除术后复发的腺样体,术野清晰,切除精确,出血少,手术时间短,周围组织无损伤,并发症少,恢复较快。     

Radiofrequency volumetric tissue reduction for treatment of turbinate hypertrophy in children

BACKGROUND: Inferior turbinate hypertrophy is one of the most common causes of nasal airway obstruction in children. Medical treatment often produces very little improvement. Radiofrequency therapy has recently been shown to be safe and effective in volumetric tissue reduction of the turbinates in adults, but no report has been published about its use in children. We prospectively evaluated the safety and effectiveness of radiofrequency volumetric tissue reduction (RVTR) for the treatment of nasal obstruction caused by inferior turbinate hypertrophy in children. METHODS: We followed up 93 children less than 9 years of age who underwent RVTR over 12 months. This surgery was performed with other procedures, such as tonsillectomy with or without grommet insertion (57 patients), tympanoplasty (10 patients), or grommet insertion alone (26 patients). Clinical examination, a medical questionnaire, and scores recorded pre- and postoperatively using Gertner-Podoshin plates were used to assess treatment outcomes 1 month, 6 months and 1 year after surgery. RESULTS: No adverse effects were encountered. One primary bleed due to tonsillectomy was the only complication in this group. Eighty-seven children (94%) had significantly improved nasal breathing postoperatively. CONCLUSIONS: The results of this study demonstrate that RVTR is a safe, effective method for the treatment of turbinate hypertrophy in children. In addition, our data demonstrates good patient acceptance over a period of 1 year.     

Radiofrequency ablation for the treatment of obstructive sleep apnea: a meta-analysis

Objectives/Hypothesis: Recent studies suggest that radiofrequency ablation (RFA) is a treatment option for patients with obstructive sleep apnea (OSA). This study investigates the effectiveness of RFA in treating OSA using a critical literature review and meta‐analysis. Study Design: Critical literature review and meta‐analysis. Methods: Two independent searches of PubMed 1966‐present were performed to identify publications pertaining to RFA and OSA. Effectiveness of the procedure was measured by comparing the Epworth Sleepiness Scale (ESS), respiratory disturbance index (RDI), and lowest O₂ saturation before and after tissue ablation. Results: Sixteen studies met the inclusion criteria. The study found a 31% reduction in short‐term ESS (odds ratios (OR) 0.69, 95% confidence interval (CI) 0.63–0.75), which was maintained beyond 12 months (OR 0.68, 95% CI 0.43–0.73). Likewise, RFA resulted in a 31% reduction in short term (<12 month) (OR 0.69, 95% CI 0.61–0.77) and 45% reduction (OR 0.55, 95% C.I. 0.45–0.72) in long‐term (>24 month) RDI levels. Short‐term results of the lowest O₂ saturations failed to demonstrate improvement (OR 1.03, 95% CI 0.88–1.20). Conclusion: RFA seems to be a clinically effective tool that reduces ESS scores and RDI levels in patients with OSA syndrome. The procedure should be considered a valid treatment option for patients who refuse or are unable to tolerate continuous positive airway pressure.     

射频消融治疗下鼻甲肥厚

目的观察射频消融治疗下鼻甲肥厚的疗效。方法对50例下鼻甲肥厚患者采用射频消融下鼻甲,观察治疗效果。结果根据鼻塞视觉模拟评分(visualanalogscale,cmVAS)判断疗效,术前平均7.77±0.96,术后6个月平均3.95±0.80,t值13.47,P值<0.01,术前术后结果有显著性差异。结论射频消融是一种有效的治疗下鼻甲肥厚的方法,并增强了同期矫正鼻、口咽双平面阻塞的OSAHS手术的安全性。     

Radiofrequency ablation of the lateral palatal space for snoring

ObjectivePilot study to examine the effect of radiofrequency ablation (RFA) of the lateral palatal fat pad in patients with socially-disruptive snoring.MethodSnoring outcomes and complications were compared between a group of patients with treated with RFA ablation of the lateral soft palate fat pad with or without inferior turbinate reduction (8 patients) and another group undergoing inferior turbinate reduction alone (12 patients).ResultsSnoring loudness and bothersomeness improved in the palate but not inferior turbinate group. Pain was mild and no major complications were observed.ConclusionThe study supports RFA ablation of the lateral palatal space as a potential low morbidity procedure for snoring.