| The chronic sinusitis, polyps are very common diseases of upper respiratory system, which estimated to affect nearly 15% of people in the world and usually accompanied by hypertrophic inferior turbinate (HIT). HIT could aggravate the symptom of nasal obstruction caused by chronic sinusitis, polyps and deflection of nasal septum (DNS),they could interact each other which would be an infernal circle. There are two sorts of HIT divided by pathology: chronic simple HIT and chronic hypertrophic HIT. Etiological treatment is most important for chronic simple HIT, while surgery is usually performed for chronic hypertrophic HIT. With the lately development of nasology, HIT usually presents the state between chronic simple one and chronic hypertrophic one, so the suitable treatment for HIT has become the focus of lately studies. With the development of endoscopic surgery (functional endoscopic sinus surgery, FESS) as well as the more recognition about the structure and function of nasal cavity, the integrity of inferior turbinate's structure and function has been more important. Though more and more studies have pay attention to find the suitable treatment for nasal diseases with least damage of inferior turbinate, no standard has been accepted.86 cases of chronic sinusitis and polyps were obtained from the department of Otolaryngology, the second hospital of JiLin University, from January of 2005 to July of 2006, which were divided into two groups: fracture group and control group, according to the fracture of inferior turbinate. Surgery: 1. fracture group: inferior turbinate fracture first, then Messerklingers performed. 2. control group: Messerklingers performed only. Index: 1. Mucociliary transport rate (MTR): The MTR was measured by"saccharin"1 day before surgery and 10 days after surgery. 2. Discharge time. 3. The rate of adherence correlated with fracture group and nasal septum. Statistical analyses: In the statistical analysis of the preoperative and postoperative findings, Exact Propability test and T test were employed by SPSS 11.0 sofeware. Results:1. Tested 1 day before operation and 10 days after operation, MTR of fracture group did not have great change(P>0.05), while MTR of the control term had great change(P <0.01), which tested 10 days after operation had been much slower than that tested 1 day before operation. Fracture of inferior turbinate could improvethe ventilation of nasal cavity as well as make least damage for the structure and function of inferior turbinate.2. The discharge time of fracture group had been shortened comparing with control term (P<0.01).3. The rate of adherence correlated with inferior turbinate and nasal septum of fracture term had declined comparing with control term(P<0.05).Conclusion:①Fracture of inferior turbinate performed easily and avoided bleeding which would make more difficultfor the FESS.②Nasal cavity could be enlarged 3-5mm owing to fracture of inferior turbinate, then there would be enough space for endoscope(4-5mm)and apparatus freely handled, o the surgery would be more smoothly.③With enough space and free-handled apparatus, the damage of nasal normal mucosa would be declined and the rate of adherence correlated with inferior turbinate and nasal septum had declined.④With least damage of nasal normal mucosa, the recovery and discharge time would be shortened.⑤Fracture of inferior turbinate could improve the ventilation of nasal cavity as well as make least damage for the structure and function of inferior turbinate which would block the infernal circle of the chronic nasal diseases, so that these diseases could be treated on the etiological basis.On the whole, performing fracture of inferior turbinate first during FESS will make important effect to maintain the structure and function of inferior turbinate , Which may afford instruction for FESS performed on the patients of chronic nasal diseases. |
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