Dusková M, Kristen M, Hronková K, Rákosník P
Department of Plastic Surgery, 3rd Medical Faculty, Charles University Hospital Královské Vinohrady, Prague.
Acta Chir Plast. 2002;44(4):124-8.
A typical cleft deformity of the central facial area is very frequently associated with impaired patency of the nose. Rhinomanometry makes it possible to assess objectively and quantitatively the patency of these airways. For objective assessment of the disorder this examination was made closely before secondary rhinoplasty in 36 patients with complete unilateral (81%) or bilateral cleft (19%). Using the method of active anterior rhinomanometry, values of nasal flow and nasal resistance were assessed. Subsequently the degree of obstruction of the nasal airways and the lateral ratio of the nasal flow were evaluated. The mean value of the total nasal flow was 239.9 cm3/s, and the mean value of nasal resistance for individual nasal vents was 3.55. The results were compared with normal values according to Bachmann. It was revealed that patients with clefts suffer in 88% of casesfrom significant obstruction of the nasal airways and In the remaining 12% of cases from mild obstruction. The lateral ratio can be evaluated as normal only in 19% and 14% of patients with unilateral and bilateral clefts respectively. Although the great majority of patients ask for secondary correction because they want to improve their appearance, It is an advantage to express objectively the functional disorder of nasal patency before surgery--thus defining the indication more accurately--and to explain to the patient the possible benefit of the operation.
典型的面部中央区域腭裂畸形常常伴有鼻通气障碍。鼻阻力测量法能够客观且定量地评估这些气道的通畅情况。为了对该病症进行客观评估,在36例完全性单侧(81%)或双侧腭裂(19%)患者进行二期鼻整形手术前不久进行了此项检查。采用主动前鼻阻力测量法,评估了鼻气流值和鼻阻力。随后评估了鼻气道阻塞程度和鼻气流的左右比例。总鼻气流平均值为239.9 cm³/s,各个鼻通气口的鼻阻力平均值为3.55。将结果与巴赫曼的正常值进行了比较。结果显示,88%的腭裂患者存在严重的鼻气道阻塞,其余12%的患者为轻度阻塞。单侧和双侧腭裂患者中,左右比例分别只有19%和14%可评估为正常。尽管绝大多数患者要求进行二期矫正手术是为了改善外观,但术前客观地表述鼻通畅功能障碍是有好处的——从而更准确地确定手术指征——并向患者解释手术可能带来的益处。