하비갑개 수술을 위한 하이브리드 술기

Abstract

Background and Objectives Inferior turbinate hypertrophy causes nasal obstruction. When conservative treatments fail, surgical intervention is needed to preserve function and allow for repeatability. This paper details a hybrid surgical technique combining submucosal microdebrider-assisted turbinoplasty (MAT) and coblation-channeling turbinoplasty (CCT) for mucosa-sparing inferior turbinate reduction. Subjects and Method This technique uses MAT for precise volume reduction of the thick medial mucosal layer (MML) and CCT (via an ArthroCare ReFlex Ultra 45 wand [ArthroCare Corporation]) to contract the venous sinusoid-rich inferior mucosal layer (IML) while careful- ly preserving the lateral mucosal layer (LML), which is crucial for humidification and muco- ciliary clearance. Procedures are typically office-based and carried out under local anesthesia. Results This hybrid turbinoplasty significantly improves nasal airway patency. For a 45-year- old male with chronic bilateral nasal obstruction, his Nasal Obstruction Symptom Evaluation (NOSE) score improved from 75 to 20 and Visual Analog Scale (VAS) from 8/10 to 2/10 6 months post-op, with preserved mucosa. For a 32-year-old female with persistent allergic rhinitis-induced obstruction, her NOSE score decreased from 65 to 15 and VAS from 7/10 to 1/10 at 6 months, showing excellent healing. No significant complications were observed. Conclusion This hybrid technique is an effective, physiologically conscious method for in- ferior turbinate reduction. Strategically targeting specific mucosal layers optimizes volume reduction while maximizing functional preservation, representing a patient-centered advance- ment in turbinate surgery.