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Indexed/Abstracted in: EMBASE, Scopus
Online ISSN 1827-188X
Ferri E., Ianniello F., Armato E., Cavaleri S., Capuzzo P.
Unità Operativa Autonoma di Otorinolaringoiatria Azienda ULSS 13 Presidio Ospedaliero di Dolo, Venezia
Background. The Argon Plasma Coagulation (APC) is a new surgical technique based on the use of a high frequency current that ionizes an inert gaz, the Argon; the Argon’s delivery produces a thermocoagulative effect interesting selectively the surface levels of the mucosa concerned. The aim of this work is to present the preliminary results of personal experience based on the use of APC in nasal, oropharyngeal and endolaryngeal surgery.
Methods. In 18 months, from March 2000 to September 2001, 381 patients with ENT pathology have undergone argon-surgery; 157 of these have undergone the decongestion of the inferior turbinates, 107 the bilateral tonsillectomy, 48 the thermocoagulation of the Locus Valsalvae’s veins, 25 the uvulopalatopharyngoplasty according to Fujita, 23 the removal of laryngeal benign neoformations, 21 the laryngeal stenosis resection.
Results. In 87% of the patients with the inferior turbinates hypertrophy, a marked improvement of the nasal airflow was observed after 12 months. The statistical analysis with Student “t”-test confirmed a significant reduction of the postoperative nasal resistances after 3, 6 and 12 months (p<0.001). Only one of the 107 patients who have undergone a tonsillectomy, has shown postoperative hemorrhagic complications. The hemostasis of the veins of Locus Valsalvae was effective in 98% of the patients. As regards the 25 patients who have undergone UVPP, after 3 months no significant sequence has been remarked with an evident reduction of night snoring. In the 23 patients who have undergone a resection in microlaryngoscopy of laryngeal benign neoformations, no morphofunctional outcome has been remarked after 1 month since the operation, either in the videolaryngoscopic control or at stroboscopy. Even in the 21 patients afflicted with laryngeal stenosis, the resection with APC was effective in all the cases.
Conclusions. The Argon Plasma Coagulation can be considered in Otorhinolaryngology a valid and effective alternative to the classic surgery techniques and to the laser surgery. The easiness of handling and use, the effective thermocoagulative superficial action and the patient’s remarkable tolerability are the most appreciable characteristics of this method. Moreover the reduction of surgery times, the increase of Day-Surgery, the absence of hemorrhagic complications and, in rhinosurgery, the complete abstention to nasal packing are re-markable.