鼻内窥镜下Nd—YAG激光治疗常年性鼻炎

鼻内窥镜下Ｎｄ－ＹＡＧ激光治疗常年性鼻炎曾强１杨滨１卢永德２王纯１我科于１９９４年７月～１９９６年１１月使用鼻内窥镜下Ｎｄ：ＹＡＧ激光烧灼筛前神经的方法治疗常年性鼻炎５４例，随诊观察疗效较好，复发率低。现报告如下：１材料和方法１１材料５４例中，男...     

鼻咽癌激光手术后放射治疗和单纯放射治疗的疗效比较

为研究鼻咽癌新的治疗手段，采用Ｎｄ：ＹＡＧ激光对６７例鼻咽喉癌者进行激光手术及颈淋巴结清扫术再用直线加速器放射治疗（放疗），并与４２例鼻咽癌单纯放疗者作比较，观察５年存活率，发现Ｎｄ：ＹＡＧ激光手术后放疗组５年生存率达７６．１％，而单纯疗效为４２．９％，认为：Ｎｄ：ＹＡＧ激光手术治疗不失为鼻咽癌治疗的一种新手段。     

Nd—YAG激光腔内照射治疗鼻,鼻窦,咽喉血管瘤46例

应用Ｎｄ－ＹＡＧ激光腔内照射治疗鼻、鼻窦、咽喉血管瘤４６例，经过１￣４年的随访，治愈率９１．３％，显效率１０．９％。同时论述静脉畸形血管瘤的临床表现及诊断．并对Ｎｄ－ＹＡＧ激光治疗血管瘤的主要方法和优越性等进行讨论。     

鼻内窥镜下Nd—YAG激光鼻腔泪囊造孔术

探讨鼻内窥镜下Ｎｄ－ＹＡＧ激光鼻腔泪囊造孔术的效果。方法：应用鼻内窥镜及ＹＡＧ激光造也治疗慢性泪囊炎２８例,并与传统手术２４例进行比较。结果术后随访６个月－３年,两组痊愈率分别为１００％和９３．３％,疗效无显著差异。     

Nd：YAG激光腔内照射治疗头颈部血管瘤234例总结

应用Ｎｄ：ＹＡＧ激光腔内照射治疗头颈部血管瘤２３４例，经过１－５年的随访，总有效率达９５．７％。并对Ｎｄ：ＹＡＧ激光治疗血管瘤的主要方法和优越性等进行讨论。     

脉冲Nd:YAG激光治疗声带小结与声带息肉的临床观察

我们采用脉冲Ｎｄ：ＹＡＧ激光治疗机治疗声带小结与声带息肉４９例,效果较好,报告如下。１　资料和方法１．１　临床资料本组４９例,男３０例,女１９例;年龄２２～６８岁,病程２个月～４年。其中声带小结２１例（均为双侧）,声带息肉２８例（单侧２６例,双侧２例）,主要症状为反复声嘶,且逐渐加重,术前均经纤维喉镜（ＦＬＳ）检查后明确诊断。１．２　设备使用ＤＬ２００型计算机程序控制脉冲Ｎｄ：ＹＡＧ激光治疗机（北京东泰吉光科技有限公司生产）,支撑喉镜,光源及喉显微手术器械。１．３　手术方法患者先行经口气管插管…     

Nd:YAG激光泪囊鼻腔造孔术治疗慢性泪囊炎21例报告

自１９９６年以来，我科对２１例（３３眼）慢性泪囊炎患者施行鼻内窥镜下Ｎｄ：ＹＡＧ激光泪囊鼻腔造孔术，随访７～２２个月，疗效满意。现报告如下。１资料与方法１．１一般资料２１例中，男６例，女１５例；年龄２８～４９岁，病史１～２８年。术前常规泪囊碘油造影，...     

YAG激光内镜治疗喉部病变

ＹＡＧ激光内镜治疗喉部病变李建中本文通过纤支镜配合激光治疗喉部病变与单纯纤支镜下手术对比观察，认为前者有其优越性，并易于推广使用。１资料与方法１．１临床资料：１９９３年７月以来，用纤支镜配合Ｎｄ－ＹＡＧ激光治疗喉部病变５３例，其中声带息肉３２例，声带...     

内窥镜Nd：YAG激光下鼻道造口复通术（附13例报告）

内窥镜Ｎｄ：ＹＡＧ激光下鼻道造口复通术（附１３例报告）林伟年，李忠华，许建设，杨宏宏，庄黎明我科自１９９４年４月起采用鼻内窥镜下Ｎｄ：ＹＡＧ激光下鼻道造口复通术，治疗上颌窦柯陆氏术后下鼻道造口闭合１３例，１７侧疗效满意，现报告如下。临床资料完整者１３...     

Nd-YAG激光治疗鼻出血疗效观察

Ｎｄ－ＹＡＧ激光治疗鼻出血疗效观察田省霞１１９９３年１０月～１９９５年１２月我们对１１５例鼻出血患者采用Ｎｄ－ＹＡＧ激光治疗，疗效好，现报告如下。１临床资料及方法１１５例中男性７２例，女性４３例，男女之比为１．５∶１，年龄８～６７岁，平均年龄３７．５...     

鼻咽癌局部复发或残留病灶的Nd：YAG激光手术挽救治疗

目的 探讨Nd:YAG激光手术挽救治疗鼻咽癌放射治疗后鼻咽局部复发或残留的可行性和临床疗效。方法在鼻内镜下经鼻腔Nd:YAG激光,对35例鼻咽癌经根治性放射治疗后鼻咽局部复发或残留病灶进行治疗。手术在局麻下进行,在鼻内镜直视下,激光功率调整在50W左右,YAG激光光纤经同侧或对侧鼻腔导入鼻咽部,气化切除肿瘤病灶。部分患者术后接受了再放射治疗,放射剂量20-60Gy不等。结果 手术均顺利完成。术后3年、5年生存率分别为51.4%、30.3%。结论 鼻内镜下Nd:YAG激光挽救手术是治疗鼻咽癌放射治疗后鼻咽局部复发或残留的有效手段,丰富了鼻咽癌放射治疗失败后的外科治疗手段。术后是否再需放射治疗,视具体情况决定。     

鼻内窥镜下钬激光泪囊鼻腔造孔术治疗慢性泪囊炎

目的 :探讨治疗慢性泪囊炎的有效方法。方法 :对 2 0例慢性泪囊炎患者在鼻内窥镜下采用钬激光泪囊鼻腔造孔术。结果 :术后随访 1～ 2年 ,术后 8个月拔管 1例 ,6个月拔管 6例 ,4个月拔管 4例 ,3个月拔管 9例。随访 1年无一例复发 ,有效率 10 0 %。无一例出现并发症。结论 :应用钬激光鼻内窥镜下行泪囊鼻腔造孔术 ,克服了传统手术的缺点 ,具有损伤小 ,面部无瘢痕 ;出血少 ,视野清晰 ;方法简便快捷 ,无须住院手术 ;并发症少等优点 ;且可作为传统手术失败后的补救措施     

Nd:YAG laser treatment of the lower turbinates with contact in hyperreflexic and allergic rhinopathy]

BACKGROUND: Nasal obstruction caused by mucosal swelling due to hyperreflectory or allergic rhinitis is a very frequent disorder. We would like to report about our first results (ENT department, University of G?ttingen) in the reduction of hyperplastic inferior turbinates by Nd:YAG Laser treatment. PATIENTS AND METHOD: One hundred seventeen patients with nasal obstruction were treated by Nd:YAG laser between October 1993 and February 1997. We used the laser in "contact mode" and all outpatients were under local anaesthesia. Follow-up was possible in 83 cases. A subjective scale was used to evaluate our results. One quarter of the patients suffered from an allergic rhinitis. RESULTS: For 80% the nasal airflow was increased. Sixty percent had excellent or good results without any nasal obstruction after therapy. The patients with allergic rhinitis performed as well as the patients with hyperreflectory rhinopathy. This improvement appeared as early as four weeks after treatment and was permanent in 37 of 40 cases with long-term observation of at least one year. Side effects: 14% reported a dry nasal mucosa for two weeks; 31% had a bloody nasal secretion for two days after treatment, but did not bleed. Fifteen percent complained of pain during the procedure. CONCLUSION: The reduction of the inferior turbinates by Nd:YAG laser is an effective treatment of equal value in symptomatic therapy of the hyperplastic turbinates due to hyperreflectory and allergic rhinopathy. Seventy-three percent of these patients would like to be treated in this way again if necessary.     

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。     

鼻内窥镜下微波热凝筛前神经治疗变应性鼻炎

目的：探讨提高变应性鼻炎疗效的方法,方法：应用鼻内窥镜下微波热凝筛前神经治疗变应性鼻炎１０６例,结果随访１年,显效８９例（８４．０％）有效１２例（１１．３％）,无效５例（４．７％）,总有效率达９５．３％。结论：鼻内窥镜下微波热凝筛前神经治疗变应性鼻炎,具有视野清楚,操作简便,疗效好等优点,值得临床应用。     

鼻内镜下Nd:YAG激光翼管神经凝固术治疗变应性鼻炎的临床研究

目的:探讨提高治疗变应性鼻炎有效方法。方法:对145例变应性鼻炎的病人,随机分为治疗组与对照组进行疗效观察,对治疗组85例采用在鼻内镜下Nd:YAG激光翼管神经凝固术治疗;对照组6O例采用微波治疗。结果:季节性变应性鼻炎治疗组有效率98.0％,与对照组(66.7％)比较P<0.01。常年性变应性鼻炎治疗组有效率94.3％,与对照组(70.0％)比较P<0.05。治疗组总有效率96.5％(82/85)。结论:鼻内镜下Nd:YAG激光翼管神经凝固术治疗变应性鼻炎,具有疗效显著,操作简单,治疗部位基本准确,创伤小,安全等优点,无鼻出血、眼干、上腭麻木、鼻孔撕裂及牙疼头疼等并发症,有较好的临床应用价值。     

Ho:YAG and diode laser treatment of hyperplastic inferior nasal turbinates

BACKGROUND: Since the early 80's, chronic nasal obstruction due to hyperplastic turbinates is treated by laser light. Comparative clinical studies were performed to assess the clinical outcome of laser assisted endonasal turbinate surgery in longterm. METHODS: By means of a pulsed Ho:YAG laser emitting light at lambda = 2100 nm (0.8 - 1.2 J/pulse, 4 - 8 Hz), 69 patients suffering from nasal obstruction due to allergic rhinitis (46 %) and vasomotor rhinitis (54 %) were treated under local anesthesia. Furthermore, 50 patients (52 % with allergic rhinitis and 48 % with vasomotor rhinitis) were treated by means of a GaAlAs-diode laser (c. w., lambda = 940 nm, 8 - 10 W). The treatment time took 3 - 10 min/turbinate and nasal packing was not necessary after the laser procedure. The study was conducted by a standardized questionnaire, photo documentation, allergy test, mucociliar function test, rhinomanometry, and acoustic rhinometry. RESULTS: Within 4 weeks after laser treatment, an improvement of nasal airflow correlating to the extent of the ablated turbinate tissue could be determined in more than 80 % of the patients. Rhinomanometry revealed a significant improvement of the nasal airflow 6 months and 1 year after the laser treatment compared to the preoperative data. Side effects like nasal dryness and pain were rare (< 5 %). Diode laser treatment revealed more effective results than Ho:YAG laser treatment, however there was no significant difference between the two investigated groups. Patients suffering from vasomotor rhinitis showed far better results in long term in comparison to allergic rhinitis patients. CONCLUSIONS: Ho:YAG and diode laser treatment can be performed as an outpatient procedure under local anesthesia in a short treatment time with promising results. It could become a time and cost effective treatment modality in endonasal laser surgery.     

慢性鼻-鼻窦炎对中耳功能的影响

目的探讨慢性鼻-鼻窦炎对中耳功能的影响。方法前瞻性研究218例慢性鼻窦炎和慢性肥厚性鼻炎患者的中耳功能,中耳功能异常的患者经鼻内镜鼻腔、鼻窦手术后复查鼓室导抗图和纯音测听。结果218例患者中28例(36耳)中耳功能异常,慢性鼻窦炎Ⅲ型患者中耳功能异常发生率显著高于慢性鼻窦炎Ⅰ型和慢性肥厚性鼻炎患者(P<0.05,P<0.01),慢性鼻窦炎Ⅱ型患者中耳功能异常发生率显著高于慢性肥厚性鼻炎患者(P<0.05)。经鼻内镜鼻腔、鼻窦手术后随访6.5月,36耳中治愈19耳,好转15耳,无效2耳。结论慢性鼻-鼻窦炎可能影响中耳功能,治疗慢性鼻-鼻窦炎有利于中耳功能恢复。     

Wedge turbinectomy: a new combined photocoagulative Nd:YAG laser technique

OBJECTIVES: To demonstrate that Nd:YAG laser photocoagulation using a combination of interstitial and contact approaches in the surgical treatment of inferior turbinate hypertrophy yields improved results in terms of postoperative nasal patency, complications, and relapse. STUDY DESIGN: A group of 121 patients with symptoms of nasal obstruction due to hypertrophied inferior turbinates were treated between January 1994 and December 1997 at the Otolaryngology-Head and Neck Surgery Unit of the Main Military Hospital of Rome using the wedge turbinectomy, a new endonasal laser technique. METHODS: This is a combined photocoagulative procedure performed under local anesthesia. In the first surgical step we perform interstitial photocoagulation using Nd:YAG laser and in the second step we use a contact approach, making two strips of photocoagulated mucosa running side by side from the tail to the head of turbinate. RESULTS: At 1-year follow-up, the complication rate in all our patients treated with this laser technique was very low and we achieved a steady improvement in nasal patency in 104 patients (85.9%). The relapse rate was approximately 14%, but we observed that 65% of the patients who experienced long-term failure were affected by allergic rhinitis. CONCLUSIONS: An accurate preoperative evaluation of the cause of the turbinate hypertrophy is fundamental to achieving better results after laser turbinectomy and reducing the risk of relapse.     

前组筛窦及上颌窦炎鼻内镜手术对早期慢性肥厚性鼻炎的疗效观察

目的：探讨前组筛窦及上颌窦炎鼻内镜手术对伴有早期慢性肥厚性鼻炎的治疗效果。方法：2003—2004年采用前组筛窦及上颌窦炎鼻内镜手术治疗早期慢性肥厚性鼻炎54例。全部病例术前均行鼻内镜及CT检查,术后随访1年以上。结果：全部病例中,50例（92．59％）术后鼻腔通气良好或改善,下鼻甲大小、形态和色泽基本接近正常或较前改善。结论：前组筛窦及上颌窦炎鼻内镜手术对伴有早期慢性肥厚性鼻炎具有较好的治疗效果,对避免下鼻甲干燥或萎缩具有积极意义。