Dynamic Incision under Nasal Endoscope and Low-Temperature Plasma Radiofrequency Ablation for Nasal Inverted Papilloma: An Analysis of Differences in Efficacy and the Destructive Effect on Immune Function.

Abstract

Methods NIP patients (n = 106) admitted between January 2020 and March 2021 were selected and grouped as follows according to the random number table method: a dissection group treated with dynamical-system surgery under nasal endoscope and an ablation group treated with LTPRA. The clinical curative effects of the two procedures were compared, and the related indexes (operation time (OT), intraoperative blood loss (IBL), and length of stay (LOS)) and postoperative adverse reactions (ARs) were counted. In addition, fasting venous blood samples were collected before treatment (T0), as well as 3 (T1) and 7 days after treatment (T2) to detect inflammatory factors (IFs; C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α)) and T lymphocyte subsets (CD3+, CD4+, and CD8+). Finally, all patients received a one-year follow-up to compare the differences in prognostic survival rate and disease recurrence rate between groups. Results The ablation group has a similar LOS to the dissection group (P > 0.05), but lower OT and IBL. No marked difference was observed between groups in terms of the total effective rate (P > 0.05), but the adverse reaction rate was higher in the dissection group compared with the ablation group (P < 0.05). Compared with T0, elevated CRP, IL-6, TNF-α, and CD3+ were observed in both cohorts at T1, with lower levels in the ablation group as compared to the dissection group, while CD4+ and CD8+ decreased in both cohorts and were higher in the ablation group (P < 0.05). Meanwhile, the levels of CRP, IL-6, TNF-α, and CD3+ in both groups were lower at T2 compared to T1, whereas those of CD4+ and CD8+ in both groups were higher at T2 compared to T1 (P < 0.05). As indicated by the statistics on prognostic follow-up, the two cohorts of patients showed no evident difference in the 1-year survival rate and disease recurrence rate (P > 0.05). Conclusions Both dynamical-system surgery under nasal endoscope and LTPRA have good therapeutic effects on NIP, but the latter is safer and can effectively reduce the postoperative inflammatory reaction of patients and maintain the stability of immune function, which has higher clinical application value.