Truilhé Y, Stoll D
C.H.U. Pellegrin, Clinique ORL et CCF, Tripode, Place Amélie Raba Léon, F-33076 Bordeaux, France.
Rev Laryngol Otol Rhinol (Bord). 2000;121(4):219-25.
Between june 1997 and september 1998, we have prospectively studied a cohort of 102 patients who were referred to ENT consultation. All patients suffered a septal deviation and a syndrome that we call "morphological". All were operated on following the Cottle's septoplasty technique. At pre- and postoperative consultation, patients were asked to answer a questionnaire and a functional evaluation of the nasal air flow was assessed by acoustic rhinometry. We have described a nasal comfort grading that we compare with the objective results as assessed by acoustic rhinometry. Our study did not permit us to find any correlation between nasal comfort and minimal cross sectional area (MCA). But evaluation of the MCA was disturbed by several methodological artifacts. A statistical correlation between the nasal comfort grading and nasal volume in the side of the septal deviation was found. The acoustic rhinometry evaluation elicited two essential observations: the first is the increase of nasal fossae volume of 30% (and, at least, 26% of the MCA). The other is a relative decrease of 45% of nasal mucosa congestion. This study shows that the nasal septum has an essential function in the pathogenesis of the so-called "morphological" functional syndrome. The morphological correction obtained by the Cottle's septoplasty acts upon the nasal vasomotricity in decreasing nasal mucosa congestion and avoid a surgical reduction of the inferior turbinate.
1997年6月至1998年9月期间，我们对102例前来耳鼻喉科会诊的患者进行了前瞻性研究。所有患者均患有鼻中隔偏曲及一种我们称为“形态学”的综合征。所有患者均采用科特尔鼻中隔成形术进行手术。在术前和术后会诊时，要求患者回答一份问卷，并通过鼻声反射测量法评估鼻气流的功能。我们描述了一种鼻舒适度分级，并将其与鼻声反射测量法评估的客观结果进行比较。我们的研究未能发现鼻舒适度与最小横截面积（MCA）之间存在任何相关性。但是，MCA的评估受到了几种方法学假象的干扰。我们发现鼻中隔偏曲侧的鼻舒适度分级与鼻腔容积之间存在统计学相关性。鼻声反射测量法评估得出了两个重要观察结果：第一个是鼻腔容积增加30%（以及至少MCA增加26%）。另一个是鼻黏膜充血相对减少45%。本研究表明，鼻中隔在所谓“形态学”功能综合征的发病机制中具有重要作用。通过科特尔鼻中隔成形术获得的形态学矫正作用于鼻血管舒缩功能，减少鼻黏膜充血，避免手术切除下鼻甲。
