Comparação das técnicas de turbinectomia com laser de CO2 e laser a diodo

Abstract

Aval iação das técnicas de turbinectomia com laser de CO 2 e da redução volumétrica das conchas nasais inferiores de maneira intersticial com o laser de diodo, em pacientes com hipertrofia do parênquima nasal. Forma de estudo: Coorte Longitudinal. Material e método: Foram avaliados 60 pacientes submetidos a estes procedimentos com um período de seguimento de 6 meses de acordo com protocolo onde foram avaliados os parâmetros de sangramento, dor e avaliação subjetiva da obstrução nasal pré e pós-operatória. Resultados: As técnicas demonstraram um baixo índice de sangramento não tendo sido necessário o tampão nasal em nenhum dos casos e alto grau de satisfação dos pacientes no quesito obstrução nasal quando comparados os valores iniciais com os resultados aos seis meses. Conclusão: Os procedimentos nas conchas nasais devem visar a melhora do quadro obstrutivo, e satisfação do paciente com pouco desconforto tanto intra como pós-operatório. As técnicas de redução volumétrica com o laser de diodo e de CO 2 mostram-se no presente estudo eficazes em 6 meses. We describe an evaluation of the techniques aiming to reduce the bulk of inferior turbinates with the diode laser and the CO 2 laser, as well as a comparison between the techniques. Study design: Longitudinal Cohort. Material and Method: Sixty patients with turbinate hypertrophy were submitted to the submucous diode laser reduction and CO 2 with a follow up period of 6 months following a established protocol concerning pain, bleeding and subjective evaluation of the nasal obstruction preoperatively and postoperatively. Results: The procedures showed a low level of bleeding and no packing was necessary in all patients. We observed that the patients were very pleased concerning the nasal obstruction postoperatively. Conclusion: The primary goal of the inferior turbinectomy is to reduce the patient complain of nasal obstruction with less discomfort, morbidity and complications during and after the procedure. The laser reduction showed in this study good results in a 6-month follow up. Further studies must be done to evaluate the results in a longer follow up. Palavras-chave: turbinectomia, laser, nariz Pedro Paulo Vivacqua da

Análise retrospectiva de cirurgias rinossinusais em um hospital escola

“…Evaluating the 153 patients resistant to medical treatment and were operated for hypertrophy of the turbinates by FESS or by another procedure, the mean age was 28.5 years with significant predominance of males (62.7%). CINTRA et al (10) found very similar average age in this study (28 years), but without predominance of either gender.…”

Thornwaldt Cyst: Case Report

“…We chose laser for excision of cyst. The use of laser in rhinology provides less bleeding [4] [12], less thermal necrosis of surrounding structures, less chances of adhesion post operatively, easy to handle, flexible, good visualisation of structures with the help of endoscope, reduced post operative pain [13]. On the other hand, the cost of the system per patient, the need for a special technician and equipment limits the use of laser [9] and also anatomical variation in nose like septal deviation, turbinate hypertrophy limits the use of nasal endoscopic approach which can be corrected.…”

Thornwaldt cyst - treatment with diode laser

“…We chose to use the diode laser, which is characterized by a small diameter fiber, flexible and easy to handle. The method allows for endonasal treatment, which ensures good visualization of the lesion and surrounding structures, making the procedure safer and efficient 5 .…”

“…The main disadvantage of using laser is its high cost 5 . The disadvantages of the endonasal procedure are represented by its anatomical changes, such as septal deviations and turbinate hypertrophy, which often prevent adequate access to the posterior nasopharynx.…”