Low W K, Willatt D J
ENT Department Hope Hospital, University of Manchester, School of Medicine, UK.
Singapore Med J. 1992 Dec;33(6):617-9.
Submucous resection (SMR) for the deviated nasal septum had been criticised to have a higher complication rate and less patient satisfaction than septoplasty. Seventy-five patients who underwent SMR were studied and followed up at 6 months to 56 months post-operatively. The rates of short and long term complications were relatively low: septal haematoma 1.3%, nasal infection 1.3%, epistaxis 2.6%, external nasal deformity 9.3% and septal perforation 2.7%. While most patients achieved short term relief of nasal obstruction (93.4%), about 30% had persistent/recurrent nasal obstruction on long term follow-up. Similar rates had been quoted for the operation of septoplasty. We postulated that this was due to unfavourable airflow patterns as a result of minor residual septal deviation. Some patients had associated pre-operative symptoms of snoring (57.3%), headache (48.0%), rhinorrhoea (38.7%), sneezing (30.7%), hyposmia (30.7%) and epistaxis (21.3%). Frequencies of cure/improvement of these symptoms after SMR were 34.9%, 33.3%, 24.1%, 30.4%, 60.9% and 43.8% respectively. The overall post-operative long term (average 23.5 months) satisfaction rate was almost 70%. SMR, being relatively easy to perform, and having similar complication and patient satisfaction rates as septoplasty, should be retained in the surgical armamentarium for the deviated nasal septum.
鼻中隔偏曲的黏膜下切除术（SMR）曾被批评其并发症发生率高于鼻中隔成形术，患者满意度也较低。对75例行SMR的患者进行了研究，并在术后6个月至56个月进行随访。短期和长期并发症发生率相对较低：鼻中隔血肿1.3%，鼻腔感染1.3%，鼻出血2.6%，鼻外形畸形9.3%，鼻中隔穿孔2.7%。虽然大多数患者短期内鼻塞得到缓解（93.4%），但约30%的患者在长期随访中仍有持续性/复发性鼻塞。鼻中隔成形术的类似发生率也有报道。我们推测这是由于轻微的鼻中隔残余偏曲导致气流模式不佳。一些患者术前伴有打鼾（57.3%）、头痛（48.0%）、流涕（38.7%）、打喷嚏（30.7%）、嗅觉减退（30.7%）和鼻出血（21.3%）等症状。SMR后这些症状的治愈/改善频率分别为34.9%、33.3%、24.1%、30.4%、60.9%和43.8%。术后长期（平均23.5个月）总体满意率近70%。SMR操作相对简单，并发症发生率和患者满意率与鼻中隔成形术相似，应保留在鼻中隔偏曲的手术治疗手段中。
