[Microdebrider polypectomy and local corticosteroids]. / Polypectomie au microdébrideur et corticothérapie locale.

OBJECTIVES: To subjectively evaluate the efficiency and tolerance of polypectomy using the microdebrider followed by local corticosteroids in nasal polyposis (NP) after medical therapy failure. METHODS: Between 2000 and 2003, a polypectomy using the microdebrider was performed in 24 patients with NP. Efficiency was evaluated retrospectively by comparing pre- and postoperative functional and polyp scores. Efficiency was also evaluated regarding extension of NP on preoperative computed tomography (CT). Overall satisfaction was evaluated using a standardized phone questionnaire. RESULTS: Mean follow-up was 23.6+/-12.5 months. The overall and individual functional scores and the anatomical score were very significantly improved after polypectomy using the microdebrider. Extension of NP on preoperative CT was not related to polypectomy efficiency. Among the patients surveyed, 87.5% were globally satisfied, 73% considered the operative conditions as satisfactory, and 83% qualified the postoperative period as simple. CONCLUSION: Polypectomy using the microdebrider followed by local corticosteroids appears to be an efficient and well-tolerated treatment for improving functional symptomatology of patients with NP.

Segmental analysis of nasal cavity compliance by acoustic rhinometry.

To explore the determinants of possible collapse of the nasal valve region, a common cause of nasal obstruction, we evaluated the mechanical properties of the nasal wall. In this study, we determined the nasal cross-sectional area-to-negative pressure ratio (nasal wall compliance) in the anterior part of the nose in six healthy subjects by measuring nasal area by acoustic rhinometry at pressures ranging from atmospheric pressure to a negative pressure of -10 cmH(2)O. Measurements were performed at baseline and after nasal mucosal decongestion (oxymetazoline). At baseline, nasal wall compliance increased progressively from the nasal valve (0.031 +/- 0.016 cm2/cmH(2)O, mean +/- SD) to the anterior and medial part of the inferior turbinate (0.045 +/- 0.024 cm2/cmH(2)O) and to the middle meatus region (0.056 +/- 0.029 cm2/cmH(2)O). After decongestant, compliances decreased and became similar in the three regions. On the basis of these results, we hypothesize that compliance of the nasal wall is partly related to mucosal blood volume and quantity of vascular tissue, which differ in the three regions, increasing from the nasal valve to the middle meatus.