İzole alt konka hipertrofisi olan hastalarda radyofrekans termal ablasyon tedavisinin nazal mukosilier klirens üzerine etkisi

Amaç: Bu çalışmada izole alt konka hipertrofisi olan hastalarda radyofrekans termal ablasyonunun nazal mukosiliyer klirens üzerindeki etkisi değerlendirildi.Hastalar ve Yöntemler: Mayıs 2009 - Aralık 2009 tarihleri arasında kliniğimize kronik burun tıkanıklığı yakınması ile başvuran ve izole alt konka submüköz hipertrofisi tanısı konulan 30 erişkin hasta 10 kadın, 20 erkek; ort. yaş 31.0±12.0 yıl; dağılım 18-61 yıl çalışma kapsamına alındı. Tedavi olarak alt konkaya üç farklı noktada 75 °C ve 350 joul olmak üzere, radyofrekans termal ablasyonu uygulandı. Nazal mukosilier klirens, ameliyat öncesi ve sonrası dönemde sekizinci hafta yapılan sakkarin klirens testi ile değerlendirildi.Bulgular: Hastaların ameliyat öncesi ve sonrası sekizinci hafta sakkarin klirens testi ortalaması sırası ile 565.4±253.9 sn. ve 558.7±257.7 sn. olarak belirlendi. Ancak iki ölçüm arasında anlamlı bir fark bulunamadı p>0.05 .Sonuç: Çalışma sonuçlarımız, alt konka hipertrofisi tedavisinde radyofrekans termal ablasyonu uygulamasının nazal mukosiliyer klirensi etkilemediğini göstermektedir

Anahtar Kelimeler:

Nasal mukosiliyer klirens, radyofrekans termal ablasyon, sakarin klirens testi

Effect of radiofrequency thermal ablation treatment on nasal mucociliary clearance in patients with isolated inferior turbinate hypertrophy

Objectives: This study aims to evaluate the effect of the radiofrequency thermal ablation on nasal mucociliary clearance in patients with isolated inferior concha hypertrophy. Patients and Methods: Thirty patients 10 females, 20 males; mean age 31.0±12.0 years; range 18 to 61 years who were admitted to our clinic with a complaint of chronic nasal obstruction and diagnosed with isolated inferior concha submucosal hypertrophy between May 2009 and December 2009 were included. Radiofrequency thermal ablation was applied to the inferior concha at three separate points with 350 joule at 75 °C as a treatment. Nasal mucociliary clearance was evaluated through saccharin clearance test in pre- and postoperative at eight weeks period. Results: The mean pre- and postoperative saccharin clearance tests were 565.4±253.9 sec and 558.7±257.7 sec, respectively. However, there was no significant difference in two measurements p>0.05 . Conclusion: Our study results show that radiofrequency thermal ablation application for the treatment of isolated inferior concha hypertrophy has no effect on nasal mucociliary clearance.

Keywords:

Nasal mucociliary clearance, radiofrequency thermal ablation, saccharin clearance test,

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Gindros G, Kantas I, Balatsouras DG, Kandiloros D, Manthos AK, Kaidoglou A. Mucosal changes in chronic hypertrophic rhinitis after surgical turbinate reduction. Eur Arch Otorhinolaryngol 2009;266:1409-16.
Porter MW, Hales NW, Nease CJ, Krempl GA. Long- term results of inferior turbinate hypertrophy with radiofrequency treatment: a new standard of care? Laryngoscope 2006;116:554-7.
Li KK, Powell NB, Riley RW, Troell RJ, Guilleminault C. Radiofrequency volumetric tissue reduction for treatment of turbinate hypertrophy: a pilot study. Otolaryngol Head Neck Surg 1998;119:569-73.
Harrill WC, Pillsbury HC 3rd, McGuirt WF, Stewart MG. Radiofrequency turbinate reduction: a NOSE evaluation. Laryngoscope 2007;117:1912-9.
Kesimci E, Bercin S, Kutluhan A, Ural A, Yamanturk B, Kanbak O. Volatile anesthetics and mucociliary clearance. Minerva Anestesiol 2008;74:107-11.
Plaza Valía P, Carrión Valero F, Marín Pardo J, Bautista Rentero D, González Monte C. Saccharin test for the study of mucociliary clearance: reference values for a Spanish population. Arch Bronconeumol 2008;44:540- 5. [Abstract]
Sun SS, Hsieh JF, Tsai SC, Ho YJ, Kao CH. The role of rhinoscintigraphy in the evaluation of nasal mucociliary clearance function in patients with sinusitis. Nucl Med Commun 2000;21:1029-32.
Jones N. The nose and paranasal sinuses physiology and anatomy. Adv Drug Deliv Rev 2001;51:5-19.
Deniz M, Uslu C, Ogredik EA, Akduman D, Gursan SO. Nasal mucociliary clearance in total laryngectomized patients. Eur Arch Otorhinolaryngol 2006;263:1099-104.
Andersen I, Camner P, Jensen PL, Philipson K, Proctor DF. Nasal clearance in monozygotic twins. Am Rev Respir Dis 1974;110:301-5.
Rutland J, Cole PJ. Nasal mucociliary clearance and ciliary beat frequency in cystic fibrosis compared with sinusitis and bronchiectasis. Thorax 1981;36:654-8.
Cavaliere M, Mottola G, Iemma M. Comparison of the effectiveness and safety of radiofrequency turbinoplasty and traditional surgical technique in treatment of inferior turbinate hypertrophy. Otolaryngol Head Neck Surg 2005;133:972-8.
Kizilkaya Z, Ceylan K, Emir H, Yavanoglu A, Unlu I, Samim E, et al. Comparison of radiofrequency tissue volume reduction and submucosal resection with microdebrider in inferior turbinate hypertrophy. Otolaryngol Head Neck Surg 2008;138:176-81.
Yildirim B, Uysal IO, Polat C, Gök C. The efficacy of radiofrequency ablation technique in patients with inferior turbinate hypertrophy. [Article in Turkish] Kulak Burun Bogaz Ihtis Derg 2008;18:90-6.
Willatt D. The evidence for reducing inferior turbinates. Rhinology 2009;47:227-36.
Jackson LE, Koch RJ. Controversies in the management of inferior turbinate hypertrophy: a comprehensive review. Plast Reconstr Surg 1999;103:300-12.
Nurse LA, Duncavage JA. Surgery of the inferior and middle turbinates. Otolaryngol Clin North Am 2009;42:295-309.
Chang CW, Ries WR. Surgical treatment of the inferior turbinate: new techniques. Curr Opin Otolaryngol Head Neck Surg 2004;12:53-7.
Tanyeri H, Boyaci Z. Reduction of the inferior turbinates with a microdebrider. Kulak Burun Bogaz Ihtis Derg 2008;18:69-73. [Abstract]
Sapci T, Usta C, Evcimik MF, Bozkurt Z, Aygun E, Karavus A, et al. Evaluation of radiofrequency thermal ablation results in inferior turbinate hypertrophies by magnetic resonance imaging. Laryngoscope 2007;117:623-7.
Nease CJ, Krempl GA. Radiofrequency treatment of turbinate hypertrophy: a randomized, blinded, placebo-controlled clinical trial. Otolaryngol Head Neck Surg 2004;130:291-9.
Won CH, Li KK, Guilleminault C. Surgical treatment of obstructive sleep apnea: upper airway and maxillomandibular surgery. Proc Am Thorac Soc 2008;5:193-9.
Cavaliere M, Mottola G, Iemma M. Monopolar and bipolar radiofrequency thermal ablation of inferior turbinates: 20-month follow-up. Otolaryngol Head Neck Surg 2007;137:256-63.
Sargon MF, Celik HH, Uslu SS, Yücel OT, Denk CC, Ceylan A. Histopathological examination of the effects of radiofrequency treatment on mucosa in patients with inferior nasal concha hypertrophy. Eur Arch Otorhinolaryngol 2009;266:231-5.
Coste A, Yona L, Blumen M, Louis B, Zerah F, Rugina M, et al. Radiofrequency is a safe and effective treatment of turbinate hypertrophy. Laryngoscope 2001;111:894-9.