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     

等离子射频消融术在鼻腔手术中的联合应用

目的:探讨在鼻腔手术中联合应用等离子射频消融术治疗下鼻甲肥大及变应性鼻炎的疗效。方法:91例伴下鼻甲肥大及变应性鼻炎的鼻中隔偏曲或鼻息肉患者,行鼻中隔成形术或鼻内镜下鼻息肉摘除加筛窦开放术后,其中62例行等离子射频消融术(消融组),29例未行等离子射频消融术(对照组)。术前及术后3个月应用视觉模拟评分表(VAS)评价鼻塞的主观感觉。根据1997年海口会议疗效评定标准判断变应性鼻炎的疗效。结果:消融组术前鼻塞VAS评分左、右侧分别为(89.5±8.7)%和(90.3±10.5)%,术后3个月分别为(26.2±8.7)%和(32.1±10.3)%,左、右侧分别与术前比较,差异有统计学意义(均P<0.01);32例变应性鼻炎患者,显效31例(96.9%),有效1例(3.1%)。对照组术前鼻塞VAS评分左、右侧分别为(90.5±8.0)%和(89.9±11.5)%,术后3个月分别为(39.2±8.9)和(48.1±8.1)%,左、右侧分别与术前比较,差异均有统计学意义(均P<0.01);16例变应性鼻炎患者,显效4例(25.0%),有效10例(62.5%),无效2例(12.5%)。两组术后VAS评分差异有统计学意义(P<0.01)。结论:在鼻腔手术中联合应用等离子射频消融术治疗下鼻甲肥大及变应性鼻炎安全、有效。     

射频消融术治疗慢性肥厚性鼻炎

目的：探讨射频消融治疗慢性肥厚性鼻炎所致鼻塞的效果及对鼻黏膜功能的影响。方法：采用射频消融术治疗慢性肥厚性鼻炎60例的双侧下鼻甲,术前及术后3个月应用视觉模拟评分表（visual analogue scale, VAS）评价鼻塞的主观感觉;应用糖精试验法测定术前及术后3个月的鼻腔黏膜纤毛输送率（mucociliary transport rate, MTR）。结果：术前鼻塞VAS评分左侧为（68.7±9.6）%,右侧为（72.5±10.2）%;术后3个月左侧为（35.0±9.0）%,右侧为（40.3±10.6）%,与术前相比,差异均有统计学意义（P＜0.01）。随访3个月,双侧下鼻甲与鼻中隔的最小距离从术前小于0.2?cm增加到术后大于0.3?cm。术前鼻黏膜纤毛MTR为（7.64±1.56）mm/min,术后3个月鼻黏膜纤毛MTR为（6.89±2.01）mm/min,与术前比较差异无统计学意义（P＞0.05）。结论：射频消融术是治疗慢性肥厚性鼻炎所致鼻塞的较好方法,对鼻黏膜纤毛无明显影响,未破坏鼻黏膜纤毛的正常生理功能     

Quantitative measurement of radiofrequency volumetric tissue reduction by multidetector CT in patients with inferior turbinate hypertrophy

Objective

To objectively assess the efficacy of radiofrequency thermal ablation of inferior turbinate hypertrophy.

Methods

Thirty-five patients with nasal obstruction secondary to inferior turbinate hypertrophy were prospectively enrolled. Radiofrequency energy was delivered to four sites in each inferior turbinate. Patients were evaluated before and 8 weeks after intervention. Subjective evaluation of nasal obstruction was performed using a visual analogue scale (VAS), and objective evaluation of the turbinate volume reduction was calculated using multidetector CT. Volumetric measurements of the preoperative inferior turbinate were compared with postoperative values on both sides.

Results

The great majority of patients (91.4%) exhibited subjective postoperative improvement. Mean obstruction (VAS) improved significantly from 7.45 ± 1.48 to 3.54 ± 1.96. Significant turbinate volume reduction was achieved by the surgery on both right and left sides [(preoperative vs. postoperative, right: 6.55 ± 1.62 cm³ vs. 5.10 ± 1.47 cm³, (P < 0.01); left: 6.72 ± 1.53 cm³ vs. 5.00 ± 1.37 cm³, (P < 0.01)] respectively.

Conclusion

Radiofrequency is a safe and effective surgical procedure in reducing turbinate volume in patients with inferior turbinate hypertrophy. Multidetector CT is an objective method of assessment in detecting radiofrequency turbinate volume reduction.     

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。     

Radiofrequency treatment of turbinate hypertrophy in subjects using continuous positive airway pressure: a randomized, double-blind, placebo-controlled clinical pilot trial.

OBJECTIVES: To estimate the treatment effect of temperature-controlled radiofrequency (TCRF) reduction of turbinate hypertrophy in patients with sleep-disordered breathing (SDB) treated with nasal continuous positive airway pressure (CPAP), and to assess the impact of study design on this estimate. STUDY DESIGN: Prospective, randomized, double-blind, placebo-controlled clinical pilot trial. METHODS: Twenty-two CPAP-treated patients with SDB with turbinate hypertrophy were randomly assigned to either TCRF turbinate treatment (mean energy 415 +/- 37 J/turbinate; n = 17) or placebo control (n = 5). Changes in nasal obstruction were evaluated between pretreatment and 4 weeks post-treatment. The primary outcome assessed changes in the blinded examiners' findings of nasal obstruction on a visual analogue scale (VAS). Secondary outcomes included blinded patients' and unblinded examiner assessments of nasal obstruction (VAS), nightly CPAP use, adherence, and tolerance, along with sleepiness and general health status scales. The treatment group findings were subtracted from the changes in the placebo group to yield treatment effect. RESULTS: The primary outcome treatment effect by VAS was -0.9 cm (95% confidence interval [CI], -2.4, 0.7), and beyond the placebo effect of -1.5 cm (95% CI: -3.4, 0.3). The secondary treatment effect of the unblinded examiner was -3.0 cm (95% CI, -4.9, -1.1). A beneficial treatment effect was also seen on every secondary outcome except general health status, but only self-reported CPAP adherence (P = .03) was statistically significant. CONCLUSIONS: TCRF turbinate treatment appears to benefit nasal obstruction and CPAP treatment for SDB. Placebo control and double blinding are critical for establishing the true treatment effect. A future definitive trial is feasible to establish statistical significance of these findings.     

鼻内镜下改良下鼻甲成形术与下鼻甲低温等离子消融加骨折外移术治疗重度慢性肥厚性鼻炎的临床对比研究

目的 将鼻内镜下改良下鼻甲成形术与下鼻甲低温等离子消融加骨折外移术治疗重度慢性肥厚性鼻炎(下鼻甲黏膜、骨膜及骨质均增生肥大、鼻甲形态异常、VAS评分重度)进行对比研究。 方法 回顾性分析124例重度慢性肥厚性鼻炎患者,按照手术方式分为A(64例)、B(60例)两组,A组采用改良下鼻甲成形术,B组采用下鼻甲低温等离子消融加骨折外移术。术前1周、术后6个月、术后12个月分别用VAS标准评分患者鼻腔症状。糖精试验评价术前1周及术后6个月两组患者鼻腔黏膜纤毛传送功能。术前1周及术后6个月测定鼻阻力,评定鼻塞改善情况。 结果 下鼻甲低温等离子消融加骨折外移术组术中出血、手术时间较改良下鼻甲成形组明显减少,且术后并发症较少;术后6个月两种患者鼻塞均有显著改善;两种手术方式对鼻腔黏膜纤毛功能均无明显影响。A组平均手术时间27.80 min、并发症发生率9.38%,B组平均手术时间19.10 min、并发症发生率6.67%。两组患者术后6个月VAS平均评分差异无统计学意义(P=0.12),术后12个月差异有统计学意义(P=0.03)。 结论 改良下鼻甲成形术与下鼻甲低温等离子消融加骨折外移术治疗重度慢性肥厚性鼻炎近期效果(6个月内)都良好,但远期效果(1年以上)改良下鼻甲成形术效果更好,因而建议对于重度慢性肥厚性鼻炎患者应因人而异精准诊疗。     

Submucosal bipolar radiofrequency therapy for treatment of turbinate hypertrophy

Disturbance of nasal airflow occurs in about 30% of human population. Turbinate hypertrophy is frequently the base of many nasal obturative diseases. The aim of this study was to determine short- term and long term effects of the radiofrequency therapy (RFT) for patients with turbinate hypertrophy. Forty- one patients with inferior turbinate hypertrophy (19 females and 22 males) were enrolled in this study prospectively. The examination included: rhinoscopy, subiective visual analogue scale (VAS) score, in which a patient described his symptoms in points from 0, (always very good nasal airflow) to 10 points (always total obstruction) and anterior rhinomanometry. The clinical assessment was before radiofrequency-turbinectomy and within the days 7 to 25 afther this therapy (follow-up 1) and 12 months later (follow-up 2). RFT was performed in local anesthesia (1% Lidocain) by means of CELON. Rhinoscopy before RFT revealed turbinate hypertrophy, which was decreased in the follow-up examination. Subjective improvement of nasal airflow was felt by 39 patients (95%) at follow-up 1. At follow-up 2 fifteen patients (37%) reported a decreased nasal airflow when compared with the follow-up 1. Rhinomanometric results were better at follow-up 1 for the left side (p = 0,0003), the right side (p = 0,0002) and both sides altogether (p = 0,0001). The improvement continued at follow-up 2 for the left side (p = 0,0004), the right side (p = 0,001) and both sides (p = 0,001) when compared with rhinomanometry before RFT. There were not statistically significant differences between the rhinomanometric results at follow-up 1 and follow-up 2. Bipolar radiofrequency thermal ablation is an effective method for the therapy of turbinate hypertrophy.     

Changes of nasal function after temperature-controlled radiofrequency tissue volume reduction for the turbinate

OBJECTIVES: Temperature-controlled and temperature-monitored radiofrequency tissue volume reduction (RFTVR) for the turbinate is a new treatment modality for nasal obstruction secondary to turbinate hypertrophy. We compared the nasal functions after the treatment ofRFTVR and laser vaporizing turbinoplasty (LVT) using subjective symptom scores and objective tests. STUDY DESIGN: Prospective, randomized clinical trial. METHODS: Twenty-four patients with nasal obstruction secondary to inferior turbinate hypertrophy were prospectively evaluated from March 1999 to October 1999 at Seoul National University Hospital (Seoul, Korea). Sixteen patients were treated with RFTVR, and eight patients with LVT. The preoperative and postoperative nasal functions were investigated by visual analogue scale of symptoms, butanol threshold test, saccharine test, acoustic rhinometry, rhinomanometry, and ciliary beat frequency. RESULTS: At 8 weeks postoperatively, the severity and the frequency of nasal obstruction improved subjectively in 81.3% and 93.8% of RFTVR group and in 87.5% and 87.5% of LVT group, respectively. Significant improvement of nasal symptoms began from 2 to 3 days after the operation in the RFTVR group, whereas there was significant improvement of nasal symptoms at 8 weeks after operation in the LVT group. However, objective nasal functions including nasal volume and total nasal resistance were significantly improved at 8 weeks after surgery in both groups. Among patients reporting symptoms of hyposmia, 55.6% of RFTVR group and 63.6% of LVT group showed improved olfaction. Saccharin transit time and ciliary beat frequency were preserved after RFTVR CONCLUSION: RFTVR for the turbinate may be useful as an alternative approach for the treatment of chronic turbinate hypertrophy.     

Submucosal bipolar radiofrequency thermal ablation of inferior turbinates: a long-term follow-up with subjective and objective assessment

OBJECTIVE: To assess the efficacy and morbidity of bipolar radiofrequency thermal ablation of the inferior turbinates in patients with nasal obstruction caused by turbinate hypertrophy. STUDY DESIGN: Prospective, nonrandomized study and outpatient treatment. METHODS: Twenty patients (age range, 23-77 y; median age, 52 y) enrolled in the study. There was one dropout. All the patients had nasal blockage despite medical treatment. Bipolar radiofrequency thermal ablation was delivered to inferior turbinates at 100 kHz with a voltage root mean square value of 168 to 182. The preoperative and postoperative nasal functions were investigated by immediate and long-term visual analogue scale (VAS) scores of symptom parameters, olfactory thresholds, saccharine transit time, rhinomanometry, and acoustic rhinometry. The follow-up was conducted at 1 week and 3, 6, and 12 months. RESULTS: The VAS scores of subjective complaints (nasal discharge, itching, sneezing, crusting) decreased, and the VAS scores of evaluation of the effectiveness (frequency of nasal obstruction, degree of nasal obstruction, and patient satisfaction) increased statistically significantly in the 12-month follow-up without relapses. There were no adverse effects on nasal epithelial clearance time and olfactory functions. In rhinomanometry the changes in total nasal resistance and response to the vasoconstrictor agent were not statistically significant. In acoustic rhinometry the change in the sum of both nasal cavity volumes from nostril to 5 cm was statistically significant 6 and 12 months after the treatments. The difference between the preoperative and postoperative vasoconstrictive effect was not statistically significant. CONCLUSION: The bipolar radiofrequency thermal ablation of inferior turbinates is a promising alternative, which should be considered when planning inferior turbinate interventions.     

Radiofrequency tissue ablation of the inferior turbinates using a thermocouple feedback electrode

OBJECTIVE: The objective of this clinical trial was to assess the safety and efficacy of radiofrequency (RF) tissue ablation of the inferior turbinates in the treatment of nasal obstruction using an RF energy delivery system with a thermocouple feedback electrode. METHODS: A prospective, nonrandomized study of 11 patients (mean age, 47+/-12 y) with chronic nasal obstruction was conducted. Using patient-based visual analogue scales (VAS), symptom parameters were assessed. These included degree of nasal obstruction, frequency of nasal obstruction, and pain. Physician assessment of nasal obstruction was also collected by the principal investigator. Follow-up was conducted at 24 hours, 1 week, 4 weeks, 8 weeks, and 1 year. ANOVA was carried out to determine statistically significant differences in the data. Data were fit to a regression model, and confidence intervals were determined from a 95% confidence level. RESULTS: In patient-assessed degree of nasal obstruction, statistical significance was seen among baseline and 4 weeks, 8 weeks, and 1 year (P<.001, P<.0001, and P<.0008, respectively). There was no difference between 8 weeks and 1 year (P<.15). The data appeared to follow an exponential decay to a constant value. The pretreatment baseline average degree of obstruction was 7.5+/-0.5 on a scale of 0 to 10. The degree of obstruction after 8 weeks was 2.7+/-0.6. The time constant for this change was 21 days to reach 90% of the final value. At 1 year, degree of obstruction was 3.3+/-0.7. For frequency of nasal obstruction, statistical significance was seen among baseline and 4 weeks, 8 weeks, and 1 year (P<.0001, P<.0001, and P<.0001, respectively). There was no difference between 8 weeks and 1 year (P<.15). The pretreatment baseline average frequency of obstruction was 7.8+/-0.5. The remaining frequency of obstruction after 8 weeks was 2.9+/-0.6. The time constant was 18 days. At 1 year, frequency of obstruction was 3.3+/-0.6. Physician assessment of nasal obstruction revealed statistical significance among baseline and 4 weeks, and baseline and 8 weeks (P<.0055 and P<.0056, respectively). There was no difference between 4 weeks and 8 weeks (P<.24). The average initial obstruction was 83%+/-4%. The remaining obstruction after 8 weeks was 58% +/-5%. The time constant was 14 days. Mild pain was reported by 55% of patients during the procedure; the remaining 45% reported no pain. Only one patient required pain medication consisting of acetaminophen after the procedure. There were no significant complications. CONCLUSIONS: Degree and frequency of nasal obstruction, as reported by patients, decreased following RF tissue ablation of the inferior turbinates. This improvement in symptoms was still evident after 1 year (P<.001). Physician assessment of obstruction also correlated with patient reports for the initial 8-week study period. The procedure was safe and well tolerated. Thermocouples within the active electrode provided additional feedback to the operating surgeon allowing the use of relatively lower tissue temperatures, power, and energy as compared with traditional techniques. These results support the need for continued research to evaluate this modality as a treatment for chronic nasal obstruction.     

凋亡相关蛋白Bcl-2和Bax在慢性鼻及鼻窦炎伴嗅觉障碍患者嗅黏膜中的表达

目的 研究Bcl-2和Bax在慢性鼻及鼻窦炎(CRS)伴嗅觉障碍患者嗅黏膜中的表达,探讨其对嗅觉神经元(olfactory receptor neurons,ORNs)凋亡的调节作用.方法 采用康涅狄格化学感受临床研究中心所采用的嗅觉检查法——CCCRC (Connecticut Chemosensory Clini...     

Short-term effect of argon plasma coagulation of the inferior turbinate in patients with perennial nasal allergy

The aim of this study was to clarify the short-term effects of argon plasma coagulation (APC) of the inferior turbinate in patients with perennial nasal allergy. In a retrospective study, 32 patients with perennial allergic rhinitis were treated by inferior turbinate reduction using APC. Grades of nasal stuffiness, rhinorrhea, sneezing, nasal airflow resistance (NAR) and overall seriousness were evaluated before and then 1-4 and 8 weeks after APC. Subjective symptoms were assessed using a questionnaire in which nasal stuffiness, rhinorrhea and sneezing were graded on a four-point scale (severe, moderate, mild and none) using the Severity Criteria of Symptoms of Nasal Allergy issued by the Japanese Society of Allergology. NAR was measured using active anterior rhinomanometry (AAR) at the 100 Pa point; this was deemed to be an objective measurement of nasal obstruction. The numbers of patients examined before and 1-4 and 8 weeks after APC were 32, 31, 25, 17, 18 and 14, respectively. Both nasal stuffiness and NAR were significantly improved 2 weeks after APC, overall seriousness was significantly improved after 3 weeks and rhinorrhea was improved after 4 weeks. Sneezing did not significantly improve during this study. There was no significant change in the grades of the examined parameters during the period between 4 and 8 weeks after APC. The beneficial effects of APC begin to appear within 2 weeks after APC and no further improvement after about 4 weeks.     

Comparison of ultrasound turbinate reduction, radiofrequency tissue ablation and submucosal cauterization in inferior turbinate hypertrophy

Chronic nasal obstruction owed to chronic hypertrophic rhinitis is a common cause of nasal airway obstruction. In cases unresponsive to conservative treatment, various surgical techniques are commonly performed, but the issue of the optimal surgical procedure is still controversial. The objective of the present study was to evaluate the effectiveness and safety of ultrasound treatment of the hypertrophied inferior turbinates, which is a technique recently applied in rhinologic surgery. We aimed, also, to compare this method with the radiofrequency cold coblation turbinate reduction and the traditional submucosal monopolar inferior turbinate cauterization. We studied prospectively 60 patients with chronic hypertrophic rhinitis of nonallergic etiology, who underwent different surgical methods of turbinate reduction, divided into two groups: (1) in 30 patients, inferior turbinate volume reduction using ultrasound procedure on the left side and monopolar diathermy on the right was performed; (2) in 30 patients, radiofrequency coblation technique on the left side and ultrasound turbinate reduction on the right side was undertaken. Subjective evaluation of nasal obstruction and pain was performed using visual analog scales and objective evaluation of the surgical outcome was obtained using active anterior rhinomanometry and acoustic rhinometry. Examinations were performed preoperatively, and 1, 3 and 6 months after surgery. Both subjective and objective evaluation showed significant postoperative improvement in all cases. The best results were obtained with the ultrasound procedure, and second with the radiofrequency technique. The least improvement was observed in the electrocautery group, although its results did not differ significantly from the radiofrequency group. It may be, thus, concluded that ultrasound turbinate reduction is an effective and safe procedure for the management of chronic hypertrophic rhinitis, in patients failing to respond to medical treatment. Using this method, better results were obtained in decreasing subjective symptoms and nasal obstruction, in comparison with radiofrequency and electrocautery.     

Comparison of the effects of radiofrequency tissue ablation,CO2 laser ablation,and partial turbinectomy applications on nasal mucociliary functions

OBJECTIVES: One of the major causes of chronic nasal airway obstruction is disease of the inferior turbinate. However, there is no agreement on how to deal with this problem. Comparison was made of the nasal functions after treatment by radiofrequency tissue ablation, laser ablation, and partial turbinectomy using subjective symptom scores and objective tests. STUDY DESIGN: Prospective, randomized clinical trial. METHODS: The study was conducted on three groups of 45 adult volunteer patients with symptoms and signs of nasal obstruction and stuffiness related to enlarged turbinates. In group A, laser ablation was applied to the inferior turbinate on one side and partial turbinectomy to the inferior turbinate on the other side. In group B, radiofrequency tissue ablation was applied to the inferior turbinate on one side and partial turbinectomy to the inferior turbinate on the other side. In group C, patients who were not treated by any surgical techniques were the control subjects. Clinical examinations, visual analogue scales, rhinomanometry, and isotopic study of nasal mucociliary transport time were used to assess treatment outcomes. RESULTS: At 12 weeks after surgery, the nasal mucociliary transport time results were compared in the same patients. The average time was 25.60 minutes on the side where laser ablation was applied and 11.40 minutes on the side where partial turbinectomy (PT) was applied. In the patients on whom radiofrequency tissue ablation and partial turbinectomy were applied, the average nasal mucociliary transport time was 10.33 minutes on the radiofrequency tissue ablation side, whereas it was 11.33 minutes on the partial turbinectomy side. Rhinomanometric measurements demonstrated a significant decrease in nasal resistances at 12 weeks in both sides in groups A and B. CONCLUSIONS: In the study it was demonstrated that radiofrequency tissue ablation to the turbinate is effective in improving nasal obstruction objectively and in preserving nasal mucociliary function. Laser ablation of the turbinate is effective in improving the nasal obstruction; however, it disturbs the mucociliary function significantly. With the partial turbinectomy technique, results obtained were similar to the results with the radiofrequency tissue ablation technique.     

低温等离子消融术与下鼻甲成形术治疗慢性鼻炎的对比研究

目的 通过研究低温等离子消融术与下鼻甲成形术术后患者鼻塞改善情况和对鼻腔黏膜纤毛功能的影响,探讨治疗慢性鼻炎更有效的方法。方法 选取慢性鼻炎患者40例,随机分为两组,分别行等离子消融术(A组)与下鼻甲成形术(B组)。术前,术后1周、1个月、3个月分别用VAS评分评价患者鼻腔症状。糖精试验评价术前及术后3个月患者鼻腔黏膜纤毛传送功能。结果 等离子组术中出血、手术时间较下鼻甲成形组明显减少,且术后并发症较少;术后3个月两组患者鼻塞均有明显改善;两种手术方式对鼻腔黏膜纤毛功能无影响。结论 对单纯黏膜肥厚的慢性鼻炎,等离子消融疗效显著;对鼻甲骨质肥厚或形态异常的慢性鼻炎,下鼻甲成形术效果好。     

Radiofrequency for inferior turbinate hypertrophy: could its long-term effect be predicted with a preoperative topical vasoconstrictor drop test?

BACKGROUND: Our purpose was to evaluate whether postoperative improvement by radiofrequency (RF) volumetric tissue reduction (RFVTR) correlated with a preoperative topical vasoconstrictor drop test (TVDT) in subjects with chronic nasal obstruction secondary to inferior turbinate hypertrophy (ITH). METHODS: This study was a prospective and unblinded clinical trial. We included 22 subjects suffering from chronic nasal obstruction secondary to ITH. TVDT was performed on all subjects before the operation, and RF energy was delivered to three different sites of each turbinate. Nasal obstruction was evaluated by visual analog score (VAS) preoperatively, after TVDT, and 1, 2, 4, 6, 8, 12, and 24t weeks after surgery. Success rates of RFVTR and gain ratios of RFVTR and TVDT were calculated. RESULTS: Significant improvements were observed in success ratios by RFVTR between the 2nd and 12th weeks. Postoperative VAS values reached to VAS value achieved by TVDT at the 8th week. Correlation analysis revealed that postoperative VAS values found at the 2nd to 24th weeks correlated positively with VAS values achieved by TVDT (r = 0.47 and p < 0.03 at the 2nd week; r = 0.65 and p = 0.001 at the 24th week) but not with preoperative VAS values. Similar positive correlations also were found between gain ratios of TVDT and RFVTR from the 4th to 24th weeks. CONCLUSION: This study showed that success by RFVTR in ITH could be predicted by preoperative TVDT. Improvement by RFVTR depends on how much the patient's turbinates respond to TVDT, but not how much he/she complains of nasal obstruction.     

Diode laser treatment of hypertrophic inferior turbinates and evaluation of the results with acoustic rhinometry

Inferior turbinate hypertrophy is the most common cause of chronic nasal obstruction. When conservative medical treatment options fail in patients with inferior turbinate hypertrophy, reduction of the inferior turbinate can be performed using surgical techniques. Laser-assisted turbinate surgery has the advantages of limited tissue trauma and reduced bleeding. We evaluated the effectiveness and outcomes of using a diode laser (λ?=?980?nm) in turbinate reduction. Our study included 62 patients with symptoms of nasal obstruction due to hypertrophic inferior turbinates, who did not respond to medical treatment (≥1?year). Patients were treated with diode laser between January 2009 and December 2010 in our ENT (ear, nose, and throat) department. Subjective outcome of severity of nasal obstruction was assessed on a standard 10-cm visual analog scale (VAS). Acoustic rhinometry was used to measure nasal patency. The cross-sectional areas 1, 2, and 3 and the volumes between 2.5 and 5.5?cm were measured. VAS scores and acoustic rhinometry measurements were performed preoperatively and 1, 6, and 12?months after surgery. The mean follow-up was 13.1?±?1?months. The mean operation time was 3?min per turbinate; no nasal packing was necessary. We did not observe any major complications. Both subjective and objective evaluations showed significant improvement. VAS scores improved, the mean MCA2, MCA3, and V2–5 measurements increased significantly 1?year after surgery. In the first year after surgery, 53 of 62 (85.4%) patients reported marked improvements in nasal breathing. Our results showed that, objectively and subjectively, the success rates in diode laser-assisted turbinate reduction were satisfactory. The diode laser, being one of the most portable and least expensive of the lasers available for turbinate surgery, makes it possible for turbinate reduction to be performed under topical anesthesia within a short period of time with excellent patient acceptance.     

Odiosoft-Rhino versus rhinomanometry in healthy subjects

CONCLUSION: Odiosoft-Rhino (OR) is a non-invasive test that is completed in an extremely short period of time. It is easy to perform and little patient cooperation is needed. OR is safe and could be used in the rhinological setting if further improved. OBJECTIVE: To evaluate nasal obstruction objectively with a new technique, OR, and to compare the results with a widely accepted method, rhinomanometry, in normal subjects. SUBJECTS AND METHODS: OR and anterior RMM were performed in 79 subjects without any rhinologic symptoms and signs. Visual analogue scales (VAS) of nasal obstruction, nasal airway resistance and nasal expiratory and inspiratory sounds were analysed. RESULTS: VAS of nasal obstruction was found to be correlated with OR findings of expiration at 2000-4000 Hz frequency interval on both sides (r = 0.564, p < 0.01 for the left side, r = 0.533, p < 0.01 for the right side). Correlations were found (p < 0.05) between left 2000-4000 Hz in expiration OR and left expiration RMM, left 4000-6000 Hz in expiration OR and left expiration RMM, right 2000-4000 Hz in expiration OR and right expiration RMM, and right 4000-6000 Hz in expiration OR and right expiration RMM. No correlation was seen between VAS, anterior RMM and OR at inspiration in any interval.     

低温等离子射频消融术治疗代偿性下鼻甲肥大

目的探索代偿性下鼻甲肥大的有效治疗方法。方法对我科105例鼻中隔偏曲伴代偿性下鼻甲肥大患者采用鼻内镜下鼻中隔矫正术后随机分为两组,50例单纯行下鼻甲外移术,55例下鼻甲外移术后在鼻内镜下对肥大的下鼻甲行低温等离子射频消融术。术后采用视觉模拟评分法（visualanaloguescale,VAS）评价患者主观的鼻塞感觉。结果随访1～3个月、4-6个月、6个月以上,对不同阶段疗效进行评价。随访6个月以上时,治疗组疗效优于对照组,有统计学意义。结论鼻内镜下低温等离子射频消融术在对肥大下鼻甲外移后,能满意的处理代偿性下鼻甲肥大,是一种有效缓解鼻塞症状的方法。