[The application of argon plasma coagulation (APC) in surgical treatment of inferior turbinates].
For over 20 years, argon plasma coagulation (APC) has been used in open surgery, in laparoscopy and in thoracoscopy for the haemostasis of superficial haemorrhages and for the resection of parenchymatous tissue. This technique is based on the use of a high-frequency current that ionizes an inert gas, the argon; the emission of this latter generates a thermocoagulative effect that is selectively exerted on the superficial surfaces of the mucosa involved. In otorhinolaryngology, it may be seen as a valid alternative to traditional surgical techniques, to a mono- or bipolar electric surgical knife, and to laser surgery. From March to November 2000, 157 patients affected by "inferior turbinate hypertrophy non-responsive to ordinary medical therapy" underwent devitalizing APC surgery. In 20% of the cases (30 patients), the operation was performed under local anaesthesia. In no case was a nasal tampon employed. Twelve months after the operation, 87% of the patients treated (136 cases) had fully resumed normal nasal respiratory functionality, with marked improvement in the air flow and reduction of the unilateral nasal resistance during rhinomanometric evaluation. There were post-operative complications in 2% of the patients (3 cases), all of which were successfully handled through APC (2 cases of epistaxis on the 7th and 9th post-operative day, and 1 case of turbino-septal synechia). In the 13% of the patients (21 cases) in whom the results had been partial or unsatisfactory, the cause of the limited efficacy of the treatment was connected with an improper use of the instrumentation, lack of compliance on the part of the patient, or a concomitant psycofunctional pathology. The statistical study, accomplished via Student's t test, confirmed that the difference between the unilateral nasal resistance values present before the procedure and those measured during the 1-month follow-up were highly significant (t = 11.126, p < .001). The same significant correlation was ascertained between the pre-operative nasal resistance values and those ascertained post-operatively, respectively at 3, 6 and 12 months (p < .001).
Ferri
E
E
Unità Operativa Autonoma di Otorinolaringoiatria, Azienda ULSS 13, Presidio Ospedaliero di Dolo, Venezia.
Ianniello
F
F
Armato
E
E
Cavaleri
S
S
Capuzzo
P
P
D000328:Adult; D001128:Argon / Q000097:blood / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000473:pathology / Q000601:surgery; D008297:Male; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D014420:Turbinates / Q000473:pathology* / Q000601:surgery*
D001128:Argon