Kantas Ilias V, Papadakis Chariton E, Balatsouras Dimitrios G, Vafiadis Marinos, Korres Stavros G, Panagiotakopoulou Aggeliki, Danielidis Vassilios
ENT Department of G. Genimmatas General Hospital, Thessaloniki, Greece.
Auris Nasus Larynx. 2007 Sep;34(3):313-7. doi: 10.1016/j.anl.2007.01.012. Epub 2007 Mar 26.
The purpose of this prospective study was to evaluate the influence of functional tension nose in nasal obstruction and to discuss its frequency and management.
Over the years 2000-2006, 153 patients underwent revision operation for nasal obstruction in our rhinoplastic center. Twenty-two of them (14.37%) suffered from functional tension nose. All 22 patients refused rhinoplasty during primary septoplasty. Sixteen of them had a kyphotic nose and the rest six cases suffered from hanging columella (drooped nose). Eighteen of them underwent primary rhinoplasty in combination with caudal diminution under general anesthesia. The other four patients refused rhinoplasty, and under local anesthesia their tip was deprojected and reprojected.
Marked improvement in nasal airflow was noted at the most recent follow-up evaluation in 20 patients out of 22 (90.91%). The mean length of follow-up was 8 months (ranging from 4 to 12 months). All follow-up results were based on office examination and pre- and post-operative computer-assisted rhinomanometry evaluation. In only two cases results were not efficient enough.
Our study strongly suggests that tension nose is a usual misdiagnosed cause of nasal obstruction. This problem is concealed under a "kyphotic", "big", or "pinocchio" nose. Usually the functional defect is spontaneously corrected during conventional rhinoplasty. However, tip should be deprojected and reprojected in cases where the patient refuses cosmetic intervention and surgeon tries to resolve his functional problem.
本前瞻性研究旨在评估功能性鼻尖张力在鼻塞中的影响，并探讨其发生率及处理方法。
在2000年至2006年期间，我们的鼻整形中心有153例患者接受了鼻塞修复手术。其中22例（14.37%）患有功能性鼻尖张力。这22例患者在初次鼻中隔成形术时均拒绝鼻整形。其中16例有驼峰鼻，其余6例患有悬垂鼻小柱（下垂鼻）。18例在全身麻醉下接受了初次鼻整形联合鼻尖缩短术。另外4例患者拒绝鼻整形，在局部麻醉下对其鼻尖进行了降低和重新抬高。
在最近的随访评估中，22例患者中有20例（90.91%）鼻气流有明显改善。平均随访时间为8个月（4至12个月）。所有随访结果均基于门诊检查以及术前和术后计算机辅助鼻阻力测量评估。只有2例效果不够理想。
我们的研究强烈表明，鼻尖张力是鼻塞常见的误诊原因。这个问题隐藏在“驼峰鼻”“大鼻子”或“匹诺曹鼻”之下。通常在传统鼻整形术中，功能缺陷会自行纠正。然而，在患者拒绝美容干预而外科医生试图解决其功能问题的情况下，应降低并重新抬高鼻尖。
