Xiao Hong-jun, Kong Wei-jia, Wang Guang-ping, Yang Cheng-zhang, Le Jian-xin
Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2006 Mar;41(3):184-6.
To explore the clinical significance and surgical technique for revisionary submucous resection of nasal septum.
Thirty-two patients who had undergone nasal septal resection were evaluated rhinologically and the causes of unsuccessful septoplasty were analysed . Based on the location and extent of deviation, the status of residual cartilage and bone, and the age of the patients, one of three incisions was chosen during septal surgeries: (1) For 5 cases with anterior, 1 with inferior and 14 with superior deviation, a "U" shaped incision at the left side of anterior edge of septum cartilage was used. (2) For 8 cases with posterior and 2 with superior deviation, the site of the incision was located just anterior to the deviation, with the aid of endoscope. (3) For 2 cases with anteroinferior deviation, because of their young age, a sublabial incision was made to surge the mucosa of the septum and base of nasal cavity, the otological electronic drill was then used.
Revision nasal septoplasty was successful in all cases. The symptoms resulting from septal deviation disappeared or significantly relieved. Following successful revision surgery, the treatment outcomes of concomitant nasal and/or sinusal diseases also significantly improved.
Revision nasal septoplasty requires different approaches depending on different clinical characteristics. A successful correction of septal deviation can not only relieve the symptoms derived from deviation, but also be of significance for the treatment of concomitant nasal and/or sinusal diseases.
探讨鼻中隔黏膜下切除术翻修的临床意义及手术技巧。
对32例行鼻中隔切除术的患者进行鼻科评估,分析鼻中隔成形术失败的原因。根据鼻中隔偏曲的部位和程度、残余软骨和骨的情况以及患者年龄,在鼻中隔手术中选择三种切口之一:(1)对于5例前部偏曲、1例下部偏曲和14例上部偏曲的患者,在鼻中隔软骨前缘左侧做“U”形切口。(2)对于8例后部偏曲和2例上部偏曲的患者,在内窥镜辅助下,切口位于偏曲前方。(3)对于2例前下部偏曲的年轻患者,做唇下切口,掀起鼻中隔和鼻腔底部黏膜,然后使用耳科电钻。
所有病例的鼻中隔翻修手术均成功。鼻中隔偏曲引起的症状消失或明显缓解。翻修手术成功后,伴发的鼻和/或鼻窦疾病的治疗效果也显著改善。
鼻中隔翻修手术需要根据不同临床特点采取不同方法。成功矫正鼻中隔偏曲不仅能缓解偏曲引起的症状,对伴发的鼻和/或鼻窦疾病的治疗也具有重要意义。