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DOI: 10.1055/a-1226-6960
Ergebnisse der Nasenmuschelverkleinerung bei alten und sehr alten Patienten mit chronischer Rhinitis
Results of inferior nasal turbinate reduction in old and very old patients with chronic rhinitis![](https://www.thieme-connect.de/media/lro/202106/lookinside/thumbnails/lro-0913_10-1055-a-1226-6960-1.jpg)
Zusammenfassung
Hintergrund Die Symptomatik der chronischen Rhinitis in der alten und sehr alten Bevölkerung kann aus der isolierten Schleimhauthyperplasie der unteren Nasenmuscheln resultieren. Als eine zielführende Therapie kommt eine Muschelplastik in Betracht. Bedenken bestehen hinsichtlich des oftmals reduzierten Allgemeinzustands, der häufig erhöhten Neigung zur Epistaxis, vor allem bei der Verwendung von Antikoagulanzien, und der Komorbiditäten wie der arteriellen Hypertonie. Hinzu kommt die Problematik der verzögerten Heilung.
Ziel In der vorliegenden Studie sollten die Ergebnisse einer Muschelplastik, die in der Gruppe der alten bzw. sehr alten Patienten erzielt wurden, mit den Ergebnissen in der Gruppe der jungen Individuen verglichen werden.
Material und Methoden Die Krankenakten von insgesamt 130 Patienten, die in drei Altersgruppen eingeteilt wurden: 82 Patienten 18–59 Jahre (M = 33,8; SD = 10,2); 30 Patienten 60–74 Jahre (M = 66,0; SD = 3,7) und 18 Patienten 75 + Jahre (M = 85,3; SD = 6,5) wurden einer Analyse unterzogen. Die Befragung der Patienten in Bezug auf die Intensität ihrer Symptome erfolgte direkt prä- und einen Monat postoperativ. Zur Beurteilung wurde der Sinonasal Outcome Test (SNOT-20) eingesetzt. Die Dauer der Heilung und die Zufriedenheitswerte der Patienten wurden ebenfalls notiert.
Ergebnisse Es zeigte sich eine vergleichbare Verbesserung des Nasendurchflusses, der Rhinorrhoe und des Postnasal-Drip-Syndroms bei den alten und sehr alten Patienten sowie den jungen Probanden. Die Funktion des Geruchssinns verbesserte sich dagegen in einem höheren Maß in der Gruppe der jungen Patienten. Die postoperative Heilung dauerte länger bei den alten und sehr alten Patienten als bei den jungen Probanden.
Fazit Einige klinische Ergebnisparameter waren bei den alten und sehr alten Patienten signifikant schlechter als bei den jungen Probanden.
Abstract
Background Symptoms of chronic rhinitis in old and very old populations may result from isolated hyperplasia of nasal inferior turbinates. Turbinoplasty is a possible method of treatment in these individuals. However, preoperative concerns are associated with their poor general condition: tendency to epistaxis, treatment with anticoagulants, hypertension, and less effective healing.
Objective The aim of this study was to determine differences in results of turbinoplasty obtained in old and very old individuals with chronic rhinitis, compared to young and otherwise healthy patients.
Material and Methods We analyzed records of 130 patients with hyperplasia of the inferior turbinates, who had undergone bipolar diathermy turbinoplasty: 82 individuals aged 18–59 (mean = 33.8; SD = 10.2), 30 patients aged 60–74 (mean = 66.0; SD = 3.7) and 18 participants aged 75 + years (mean = 85.3; SD = 6.5). The patients were questioned about the intensity of their symptoms before and one month after the surgery, using the SNOT-20 questionnaire. The duration of wound healing and satisfaction scores were also noted.
Results Nasal patency, nasal discharge and post-nasal drip improved in old and very old patients, similarly as in the young ones. Olfactory and taste function improved significantly more in young individuals. Postoperative healing time was significantly longer in very old patients.
Conclusions Some results of turbinoplasty in old and very old patients were significantly worse than in young ones.
Schlüsselwörter
Nase - Rhinosinusitis - untere Nasenmuscheln - Muschelplastik - alte Patienten - HeilungPublication History
Received: 21 June 2020
Accepted: 22 July 2020
Article published online:
21 August 2020
© 2020. Thieme. All rights reserved.
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