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題 名 | Power Microdebrider-Assisted Modification of Endoscopic Inferior Turbinoplasty: A Preliminary Report=使用微形吸絞器之改良型內視鏡式下鼻甲整形術:初步報告 |
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作 者 | 李杰峰; 陳泰安; |
書刊名 | 長庚醫學 |
卷 期 | 27:5 2004.05[民93.05] |
頁 次 | 頁359-365 |
分類號 | 416.41 |
關鍵詞 | 微形吸絞器; 內視鏡; 鼻甲整形術; Microdebrider; Endoscopic; Turbinoplasty; |
語 文 | 英文(English) |
中文摘要 | 背景:在本文中,我們將介紹一種使用微型吸絞器的內視鏡下鼻甲整形術,其片點在於分離鼻黏膜瓣時能得到較優異的視野,並可針對病人的需求做出更適切的下鼻甲修剪。 方法:從2001年11月到2002年12月之間,共有29位患有慢性肥厚性鼻炎的病人接受此等使用微形吸絞器的內視鏡手術方式,並進行術後的追蹤檢查。評估項目包括有主觀性的問卷調查及客觀性的鼻阻力檢查。這些病人的術後平均追蹤時程為15.3個月。 結果:在本次研究中,鼻塞的整體改善率達到了91%。共有22位病人在術前一週及術後兩個月時接受鼻阻力檢查,其鼻腔通氣量平均每分鐘增加了187毫升。此外,對頭痛的症狀也達到完全的緩解。但在持續性鼻漏及鼻倒流等方面的成效則並不顯著,各只58%及54%的改善率。至今尚未發現有萎縮性變化或永久性的沾黏產生。 結論:對慢性肥厚性鼻炎的患者來說,使用強力器械的內視鏡式鼻甲整形術是一種安全、簡單且有效的治療方式;尤其是在合併內視鏡式的中膈或鼻竇手術時,更能感受到它的方便、易操作。此等術式提供了另一種微創切除的治療選擇,然而仍需進一步的前瞻性研究來予以佐證。 |
英文摘要 | Backgorund: In this article, microdebrider-assisted modification of endoscopic inferior turbinoplasty is described. It has the advantage of superior visualization during elevation of the mucosal flap and allows precise tailoring of the resection to the needs of patients. Methods: From November 2001 to December 2002, 29 patients with chroic hypertrophic rhinitis treated with power endoscopic inferior turbinoplasty was available for follow-up examinations. Questionnaires and rhinomanometric studies were performed for subjective and objective evaluations. These patients were followed up for an average of 15.3 months after the operation. Results: The overall improvement in nasal obstruction was 91% in our study. Twenty-two patients received rhinomanometric studies 1 week preoperatively and 2 months postoperatively. The average nasal airflow was increased by 187 ml/min. In addition, complete relief of headaches was achieved. But the remission rates of persistent rhinorrhae and post-nasal dripping were less significant, at about 58% and 54%, respectively. Atrophic change and permanent synechiae had not yet been observed. Conclusions: Power endoscopic turbintoplasty is a safe, simple, and effective method for the treatment of chronic hypertrophic rhinitis. It is especially handy in adjunct to endoscopic septoplasty or sinosurgery, and appears to provide a surgical choice of a minimally invasive technique. However, further study with a prospective design is needed to strengthen the evidence. |