鼻内镜下鼻甲黏膜下成形术治疗慢性肥厚性鼻炎的临床体会

目的：总结鼻内镜下鼻甲黏膜下成形术治疗慢性肥厚性鼻炎的经验。方法：采用XPS 3000手术综合动力系统配备专用下鼻甲切削刀头对25例慢性肥厚性鼻炎患者行内镜下鼻甲黏膜下成形术（A组）,同时将选择行常规下鼻甲部分切除术的22例患者(B组)作为对照,比较两组的术中出血量、手术时间、鼻腔通气时间和黏膜恢复时间。结果：下鼻甲黏膜下成形术的术中出血量、手术时间、鼻腔通气时间和黏膜恢复时间比传统下鼻甲切除术要少和短,两组比较差异有统计学意义(P＜0.05)。术后随访3个月,A、B两组的有效率分别为92%及86%,下鼻甲黏膜下成形术疗效更好。结论：内镜下鼻甲黏膜下成形术比传统的下鼻甲部分切除术创伤更小,术后疗效更好,值得临床进一步推广应用。     

鼻内镜下鼻甲黏膜下切除治疗慢性肥厚性鼻炎172例

慢性肥厚性鼻炎是以黏膜、黏膜下层、甚至骨质的局限性或弥漫性增生肥厚为特点的鼻腔慢性炎症[1],常用的治疗方法有药物治疗、微波、下鼻甲部分切除等,此类治疗方法均对下鼻甲黏膜的正常功能有一定的损害,2007年1月~2010年1月我科采用下鼻甲黏膜下切除治疗慢性肥厚性鼻炎172例,取得满意的疗效,现报道如下。     

鼻内镜下下鼻甲重塑治疗慢性肥厚性鼻炎

目的 探讨治疗慢性肥厚性鼻炎较理想的手术方法 .方法 在鼻内镜下切除部分肥厚的黏膜下组织和(或)下鼻甲骨,治疗慢性肥厚性鼻炎36例.结果 术后随访3-6月,显效29例(80.6%),有效6例(16.7%),无效1例(2.7%),总有效率(97.3%),无并发症发生.结论 下鼻甲重塑治疗慢性肥厚性鼻炎是一种较理想手术方法 ,值得临床推广.     

鼻内镜下鼻甲成形术治疗慢性肥厚性鼻炎60例

目的：探讨保全鼻甲生理功能手术治疗慢性肥厚性鼻炎的方法及疗效。方法：行鼻内镜下鼻甲成形术60例,其中下鼻甲黏膜下组织楔形切除40例及下鼻甲黏膜下组织楔形切除＋下鼻甲骨部分切除20例,术前、术后测定鼻甲黏膜纤毛清除时间及鼻腔分泌物的pH值。结果：鼻内镜手术疗效好、患者痛苦小,出血少,结痂少,鼻甲形态好,术后康复快,术后2个月下鼻甲黏膜纤毛清除时间及鼻腔分泌物pH值基本正常。结论：鼻内镜下鼻甲成形术治疗慢性肥厚性鼻炎疗效可靠,是一种符合生理微创的手术方法。     

经鼻内镜低温等离子下鼻甲消融术治疗青少年肥厚性鼻炎

目的观察低温等离子射频治疗青少年慢性肥厚性鼻炎的临床疗效。方法采用ENTec—CoblatorTM等离子治疗仪对38例下鼻甲肥大患者行双侧下鼻甲低温消融术。结果术后3个月随访,治愈32例（84．2％）、好转4例（10．5％）、无效2例（5．3％）,总有效率94．7％。结论低温等离子射频消融术是治疗青少年慢性肥厚性鼻炎微创、安全和有效的方法,为临床提供了一个良好的治疗手段。     

鼻内窥镜下鼻甲成形术治疗慢性肥厚性鼻炎

慢性肥厚性鼻炎一般采用鼻腔滴药、口服中成药、局部封闭、注射硬化剂及冷冻、烧灼等治疗 ,效果均较差 ,常需手术治疗。我科 1 998年以来应用鼻内窥镜行下鼻甲成形术治疗本病 ,疗效满意。报告如下。1　资料与方法1 .1　临床资料本组 1 72例 ( 2 60侧 )中 ,男 1 1 3例 ( 1 76侧     

鼻内镜下鼻甲黏膜下切除术

2000年3月～2006年2月我院经鼻内镜行下鼻甲黏膜下部分切除术治疗慢性肥厚性鼻炎73例,现报道如下.     

鼻内镜下鼻甲骨折外移联合射频消融术治疗慢性肥厚性鼻炎的疗效分析

目的鼻内镜下鼻甲骨折外移联合射频消融术治疗慢性肥厚性鼻炎疗效分析。方法对98例下鼻甲肥大的慢性肥厚性鼻炎患者施行鼻内镜下下鼻甲骨折外移联合射频消融术,术后1周、1个月、2个月复诊,最后一次复诊时评价疗效。结果98例慢性鼻炎患者中,术后2个月复诊示显效88例,占89.79%;有效6例,占6.12%,总有效率为95.92%。仅2例患者发生鼻腔粘连,并发症发生率为2.04%。结论鼻内镜下下鼻甲骨折外移术联合射频消融术治疗慢性肥厚性鼻炎效果良好,术后并发症发生率低。     

鼻内镜手术治疗慢性肥厚性鼻炎

1998～2000年,采用鼻内镜手术治疗37例慢性肥厚性鼻炎,报道如下. 1 资料与方法 1.1 临床资料.37例中,男25例,女12例;年龄在20～46岁;病程1～10年不等.患者均以鼻塞为主诉,并且经反复药物治疗无明显好转.专科检查:下鼻甲肥大或息肉样变,暗红色或灰白色,用1%麻黄素收缩效果欠佳,鼻腔内有黏液性分泌物,中鼻甲黏膜和钩突黏膜水肿,鼻中隔无明显偏曲.     

鼻内镜手术治疗慢性肥厚性鼻炎

慢性肥厚性鼻炎是耳鼻咽喉头颈外科的常见病和多发病,药物治疗往往无效。近年来不少学者采用射频[1]、激光[2]、微波[3]、下鼻甲成形术等方法治疗慢性肥厚性鼻炎,在临床上获得了一定的疗效,但这些方法不同程度地损伤了下鼻甲黏膜的上皮层、基底层及固有层。1998～2000年,我们采用鼻内镜手术治疗37例慢性肥厚性鼻炎,报道如下。1资料与方1.1临床资料。37例中,男25例,女12例;年龄在20～46岁之间;病程1～10年不等。患者均以鼻塞为主诉,并且经反复药物治疗无明显好转。专科检查:下鼻甲肥大或息肉样变,暗红色或灰白色,用1%麻黄素收缩效果欠佳,鼻腔…     

鼻腔外侧壁黏骨膜下下鼻甲部分切除术治疗慢性肥厚性鼻炎

目的探讨鼻腔外侧壁黏骨膜下下鼻甲部分切除术治疗慢性肥厚性鼻炎的疗效,并介绍鼻腔外侧壁黏骨膜下下鼻甲部分切除术的手术方法。方法28例慢性肥厚性鼻炎患者,鼻窦CT证实下鼻甲骨性肥大,行鼻腔外侧壁黏骨膜下下鼻甲部分切除术,术前及术后3、12个月检查鼻阻力（nasal airway resistance,NAR）及应用VAS（visual analogue scale）评分法评价鼻通气功能。结果28例患者中痊愈20例,好转6例,无效2例。无鼻腔干燥、结痂、粘连、鼻泪管开口闭锁等并发症,下鼻甲形态满意。结论经鼻腔外侧壁黏骨膜下下鼻甲部分切除术是治疗慢性肥厚性鼻炎的有效方法。     

下鼻甲骨粘骨膜下部分切除术60例报告

目的评估下鼻甲骨粘骨膜下部分切除术治疗慢性鼻炎的疗效,结合病理检查探讨下鼻甲骨在慢性鼻炎发病机制中的作用.方法回顾分析60例下鼻甲骨粘骨膜下部分切除术治疗慢性鼻炎的临床资料及随访资料.结果60例下鼻甲骨粘骨膜下部分切除术治疗慢性鼻炎,疗效满意,无严重并发症发生.结论下鼻甲骨粘骨膜下部分切除术是治疗慢性鼻炎安全、有效的方法;下鼻甲骨在慢性鼻炎发病机制中起一定的作用.     

中下甲部分切除术治疗血管运动性鼻炎

目的评价中下甲部分切除术治疗血管运动性鼻炎(VR)的临床效果.方法将126例VR患者随机分成3组,每组42例,A组行双侧中下甲黏膜激光烧灼;B组行筛前神经和翼管神经电灼术;C组行中下甲部分切除术.合并鼻中隔偏曲者同时行鼻中隔黏膜下切除术.术后1个月、半年、1年和5年各随访1次,比较3组术后症状,术后并发症和复发率.结果3组患者术后症状均消失.但随着随访时间的延长,均有部分病例复发.术后1～6个月复发者以A、B两组较多,差异无显著性,术后1～5年,A、B两组复发率达80%～90%,复发后的症状评分与术前相同.而C组术后近期复发率低(术后6个月为4.76%),5年后随访复发率为26.19%,复发者症状评分(5.18±1.07)明显低于手术前(8.46±1.38).结论中下甲部分切除术治疗VR效果好,复发率低,并发症少,且手术操作简单,是目前治疗VR的最佳手术方案.     

Inferior turbinectomy versus submucosal diathermy for inferior turbinate hypertrophy

In order to compare and evaluate bilateral inferior turbinectomy (BIT) and submucosal diathermy (SMD), we retrospectively examined these two well-known techniques for treatment of nasal obstruction due to bilateral congestion of the inferior turbinates. One hundred patients with bilateral nasal obstruction were divided into 4 groups according to their nasal airflow patency. Forty-nine patients underwent BIT, and 51 patients underwent SMD. All 100 patients were followed for 2 months after surgery. Patients with difficult postoperative courses were followed up to 1 year after surgery, in order to decide on the necessity of operative revision. Postoperative improvement in nasal breathing after BIT was reported for 96% of patients 2 weeks after surgery, and for 88% 2 months after surgery. Only 1 BIT patient had to undergo revision operation. Diathermy showed good results in 78% of cases 2 weeks after surgery. The efficacy of the procedure was reduced to 76% 2 months after surgery. Twenty percent of SMD patients were advised to undergo operative revision. Postoperative bleeding occurred in 20% of BIT patients and in only 4% of SMD patients. We found that the extent of postoperative improvement does not depend on preoperative conditions; therefore, it is impossible to predict the extent of postoperative improvement on the basis of the results of preoperative assessment. Both procedures can be performed under local anesthesia, are relatively safe and effective, and do not need expensive instrumentation that may not be available in many medical centers.     

86例慢性肥厚性鼻炎手术治疗的临床疗效分析

目的:比较手术和微波热凝术治疗慢性肥厚性鼻炎的疗效。方法:86例患者,其中男性51例(59.3％),女性35例(40.7％),随机分为两组,一组(43例)采用下鼻甲部分切除术(PIT),另一组(43例)用微波热凝术(MTC)进行治疗。结果:PIT组1年后鼻通气改善38例(88.37％);MTC组1年后鼻通气改善27例(62.79％),经检验X~2=7.62,P=0.006,差异有显著性。2～5年后鼻通气改善PIT组35例(81.40％);MTC组2～5年后鼻通气改善11例(25.58％)。经检验X~2=7.62,P=0.000。结论:对慢性肥厚性鼻炎伴骨质增生的病人运用PIT具有良好的近期效果和远期效果,优于MTC。     

S M R of inferior turbinate in chronic hypertrophic rhinitis

A study was undertaken to evaluate the role of unilatcral/bilateral submucous resection of the inferior turbinates in fifty cases of chronic hypertrophic rhinitis. Patients associated with deflected nasal septum or sinus infectious were excluded from the study. Decongesiton of turbinates was done to exclude the cases with predominantly mucosal hypertrophy. Gertner (1984) plate method was used to asses the nasal patency preoperatively and then post-operatively at 1, 3 and 6 months follow up. The analysis of observations made revealed SMR of inferior turbinate to be a very effective modality tor relieving nasal obstruction due to bony turbinal hypertrophy. The procedure has least interference with nasal mucosal integrity and functions and complications associated with the procedure have been found to be minimal. Histopathological examination of mucosa and of ostenid tissue revealed infiltration by chronic inflammatory cells suggesting chronic nonspecific inflammation either due to non-specific infections and / or allergy).     

Submucous diathermy of the inferior turbinates in chronic hypertrophic rhinitis

Twenty patients, 10 allergic and 10 non-allergic, with chronic hypertrophic rhinitis and presenting mainly with bilateral nasal obstruction were subjected to submucosal diathermy of their inferior turbinates. There was significant post-operative improvement clinically, histopathologically and histochemically in the non-allergic group, while the improvement was less obvious in the allergic cases. The post-operative clinical improvement as regards rhinorrhea and sneezing was not as marked as that for nasal obstruction. Evaluation of the results showed that submucous diathermy of inferior turbinates is a good line of treatment for cases of chronic hypertrophic rhinitis, with better results in the non-allergic group of patients.     

Clinical effects of submucosal middle turbinectomy for eosinophilic chronic rhinosinusitis

Objective

The preservation or resection of the middle turbinate (MT) during endoscopic sinus surgery (ESS) currently remains a matter of debate. The present study aimed to investigate the effects of submucosal middle turbinectomy (SMT) in ESS for eosinophilic chronic rhinosinusitis (ECRS).