Electroacupuncture compound anesthesia in radiofrequency ablation for hypertrophic inferior turbinate:a randomized controlled trial

Objective To explore the feasibility of electroacupuncture compound anesthesia in radiofrequency ablation for hypertrophic inferior turbinate.Methods The patients confirmed to the enrolled criteria were randomly divided into an observation group（n=31） and a control group（n=30）.In the observation group,electroacupuncture was applied to Sìbái（四白 ST 2）,Xiàguān（下关 ST 7）,Hégǔ（合谷 LI 4） and Zhīgōu（支沟 TE 6） on the left side for the anesthesia and the routine local anesthesia was done on the right side.In the control group,the routine local anesthesia was adopted on both sides.The feelings of pain,circulatory index and operation effect were observed and compared between the two groups.Results During radiofrequency ablation,the pain grades of two measurements on the left side and the 2nd measurement on the right in the observation group were all lower than those in the control group（all P〈0.05）.In the observation group,the pain grade on the left side was lower than that on the right side（P〈0.05）,and the systolic blood pressure and the heart rate were lower than those in the control group when undergoing the 2nd radiofrequency ablation on the right side and on the left side,respectively（all P〈0.05）.There was no significant difference in operation effect between the two groups.Conclusion Electroacupuncture compound anesthesia can meet the analgesia requirement of radiofrequency ablation for hypertrophic inferior turbinate,and would be helpful to prevent cyclic fluctuation during the operation at the same time.

Nasal septum suture combined with inferior turbinate coblation after septoplasty: Does it improve quality of life and reduce complications?

Objective:Nasal packing is routinely applied after septoplasty.Patients,however,report feeling very uncomfortable while the packing is in place.The aim of this study was to compare the effects of nasal septum suture combined with inferior turbinate coblation to the effects of nasal packing after septoplasty.Methods:In this study,135 patients undergoing septoplasty were divided into 3 groups:group 1 patients had microdebrider with packing,group 2 received coblation with packing and group 3 had coblation with suture.Early postoperative quality of life and complications were compared between the 3 groups.Results:The patients in group 1 experienced the most postoperative nasal pain,headache,dysphagia,sleep disturbance and bleeding on the night of surgery;while the patients in group 3 experienced the fewest symptoms.No difference in epiphora was observed between the 3 groups.More pain and bleeding were experienced when comparing the pack removal (Group 1 and 2) with the clearance of the nasal cavity (Group 3).We noted one case of postoperative bleeding in group 1,one septal hematoma in group 1 and a second septal hematoma in group 2.No such postoperative complications were found in group 3.Conclusion:Nasal septum suture combined with inferior turbinate coblation was not only associated with less pain,increased patient satisfaction and an improved quality of life;but also reduced postoperative complications.Our results confirm that it is a more comfortable,reliable alternative to the more common nasal packing.

低温等离子射频消融联合下鼻甲骨折外移术治疗阻塞性睡眠呼吸暂停低通气综合征的疗效观察

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者接受低温等离子射频消融联合下鼻甲骨折外移术后睡眠及经鼻持续气道正压通气(nasal continuous positive airway pressure,nCPAP)治疗耐受性的改善情况。方法选择40例OSAHS合并双侧下鼻甲肥大的患者作为研究对象,均在局麻下接受下鼻甲低温等离子射频消融联合骨折外移术。术前及术后2周分别采用多导睡眠监测(PSG)、鼻阻力仪、autoCPAP呼吸机及视觉模拟量表(VAS)测定睡眠呼吸暂停低通气指数(AHI)、最低血氧饱和度(lowest oxygen saturation,LSaO_(2))、鼻气道阻力及nCPAP治疗耐受性。结果与术前比较,术后2周时患者AHI降低至(35.17±9.72)次/h,LSaO_(2)提高至(83.21±6.58)%,鼻气道阻力降低至(0.55±0.09)kPa·s/cm^(3),VAS评分升高至8.32±1.17,差异比较均有统计学意义(P均<0.05)。结论低温等离子射频消融联合下鼻甲骨折外移术能有效降低OSAHS患者的鼻阻力,提高nCPAP治疗的耐受性,改善OSAHS患者的睡眠情况。

Endoscopic nasal surgery for mucocele and pyogenic mucocele of turbinate: Three case reports

BACKGROUND Cases of turbinate mucocele or pyogenic mucocele are extremely rare.During nasal endoscopy,turbinate hypertrophy can be detected in patients with turbinate or pyogenic mucocele.However,in many instances,differentiating between turbinate hypertrophy and turbinate mucocele is difficult.Radiological examinations,such as computed tomography(CT)or magnetic resonance imaging(MRI),are essential for the accurate diagnosis of turbinate mucocele.Herein,we report three cases of mucocele or pyogenic mucocele of turbinate,including their clinical presentation,imaging findings,and treatments,to help rhinologists understand this condition better.CASE SUMMARY Three cases of turbinate and pyogenic mucocele were encountered in our hospital.In all patients,nasal obstruction and headache were the most common symptoms,and physical examination revealed hypertrophic turbinates.On CT scan,mucocele appeared as non-enhancing,homogeneous,hypodense,well-defined,rounded,and expansile lesions.Meanwhile,MRI clearly illustrated the cystic nature of the lesion on T2 sequences.Two patients with inferior turbinate mucocele underwent mucocele lining removal,while the patient with pyogenic mucocele underwent endoscopic middle turbinate marsupialization.The patients were followed up on the first,third,sixth month,and 1 year after discharge,and no complaints of headache and nasal congestion were reported during this period.CONCLUSION In conclusion,both CT and MRI are helpful in the diagnosis of turbinate or pyogenic mucocele.Additionally,endoscopic nasal surgery is considered to be the most effective treatment method.

Extranasopharyngeal angiofibroma in children:A case report

BACKGROUND Sporadic cases of extranasopharyngeal angiofibroma in children,especially preschool children,have been reported in the literature.CASE SUMMARY We present a case of extranasopharyngeal angiofibroma in a 4-year-old boy.The presenting symptoms,imaging findings,treatment,histological appearance,and follow-up data are described in detail.For this patient,we performed embolization on two occasions,and then,resected the tumor completely.During the treatment,the patient developed a soft-palate perforation due to aseptic necrosis.However,the healing ability was good,and the perforation healed spontaneously.We additionally reviewed all pediatric cases of extranasopharyngeal angiofibroma published up to 30 June 2020 in the PubMed,Baidu Scholar,Scopus,and Web of Science databases.We identified 45 pediatric patients[average(10.98±4.86),boys 39(86.7%)].The highest proportion of cases occurred in adolescence[22(48.9%)].The top three sites of occurrence of extranasopharyngeal angiofibroma in children were the maxillary sinus,nasal septum,and inferior turbinate.CONCLUSION Extranasopharyngeal angiofibromas can occur throughout childhood,and predominantly present with nasal obstruction and spontaneous rhinorrhagia.

Intranasal endoscopic prelacrimal recess approach to maxillary sinus

Background The inferior turbinate （IT） and nasolacrimal duct （NLD） are often sacrificed while managing the diffuse lesion of maxillary sinus （MS）. We report a new approach to MS without ablation of NLD and IT. Methods This retrospective study enrolled 19 hospitalized patients （aged from 42 to 68 years） who underwent endoscopic sinus surgery between 2003 and 2008. Twelve patients had inverted papilloma （IP）, two had nasal polyps, two had Kubo＇s postoperative cyst of MS, one had recurrent bone cyst of maxilla, one had dentigerous cyst and one had bleeding of internal maxillary artery secondary to CaldwelI-Luc operation respectively. Two IP patients were excluded from this group since the follow-up time was less than 12 months. The NLD was dissected after removing the anterior bony portion of nasal lateral wall. The prelacrimal recess approach （PLRA） to MS was established when IT-NLD flap was raised medially. The flap was repositioned when MS lesion was removed. Results All the 17 patients had unilateral lesions. Ten MS IP patients were at the T3 Krouse stage. The follow-up ranged from 7 to 60 months. No recurrence was seen in 16 patients. Only one IP patient had a local recurrence in MS. All of them had no any complications. Conclusion The diffuse or severe diseases of MS may be the potential indications for PLRA.