Endoscopic Posterior Nasal Neurectomy Using the Coblator System

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  • Tabata Takahisa
    Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, University of Occupational and Environmental Health
  • Kitamura Takuro
    Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, University of Occupational and Environmental Health
  • Hohchi Nobusuke
    Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, University of Occupational and Environmental Health
  • Kise Yasuhiro
    Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, University of Occupational and Environmental Health
  • Takenaga Fumiko
    Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, University of Occupational and Environmental Health
  • Koizumi Hiroki
    Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, University of Occupational and Environmental Health
  • Suzuki Hideaki
    Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, University of Occupational and Environmental Health

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Other Title
  • 後鼻神経切断術における高周波バイポーラシステム（コブレーター<sup>®</sup>）の応用

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<p>Objective: The present study was aimed at evaluating the usefulness of a high frequency bipolar system (Coblator system) as a cutting device for posterior nasal neurectomy (PNN) in patients with allergic rhinitis.</p><p>Methods: Nineteen patients with intractable allergic rhinitis who underwent PNN in our hospitals were enrolled in this study. There were 16 men and 3 women ranging in age from 14 to 73 years old. The Coblator system was used in 9 patients (Coblator group) and the ultrasonic scalpel was used in the other 10 patients (control group). All surgical procedures were performed endoscopically under general anesthesia. The middle meatus mucosa posterior to the maxillary sinus ostium was cut and elevated to approach the posterior nasal nerve. A cord-like structure emerging from the sphenopalatine foramen that included the sphenopalatine artery and posterior nasal nerve was identified and severed using the Coblator system or ultrasonic scalpel. Patients’ medical records were reviewed and analyzed retrospectively.</p><p>Results: There was no significant difference in the peripheral blood eosinophil count or total serum IgE level between the two groups. The Coblator systems exhibited maneuverability, caused less bleeding and provided a less obstructed operative view compared to the ultrasonic scalpel. Mean operation time was significantly shorter in the Coblator group compared to the control group (8.6 ± 1.3 min vs. 17.9 ± 1.7 min; P<0.001). The percentage of patients with nasal discharge significantly decreased after surgery in the Coblator group (9/9 preoperatively vs. 3/9 postoperatively; P = 0.009).</p><p>Conclusion: The Coblator system is a more useful device compared to the ultrasonic scalpel for PNN.</p>

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