Buyuklu Fuat, Cakmak Ozcan, Hizal Evren, Donmez Fuldem Yildirim
Ankara, Turkey From the Departments of Otorhinolaryngology and Radiology, Baskent University Faculty of Medicine.
Plast Reconstr Surg. 2009 Jun;123(6):1704-1709. doi: 10.1097/PRS.0b013e31819b69b1. Epub 2009 Mar 23.
Various surgical treatment modalities are available for inferior turbinate (IT) hypertrophy. Each is related with well-established complications, but still there is a lack of consensus on the optimal technique. Outfracture of the IT is thought to be a minimal destructive procedure among all other reductive turbinate interventions. Our aim was to assess the long term effects of IT outfracture technique in patients with mild or moderate IT hypertrophies. METHODS: Twenty ITs in 10 patients were outfractured during a septoplasty procedure. The distance of the IT bone to the lateral nasal wall was compared at 3 different levels of the nasal passage before and after (at 9 months) surgery with computed tomography scans of each patient at (1) the first section in which the IT bone could be seen entirely (anterior portion), (2) the level of the maxillary sinus ostium (middle portion), (3) the last section in which the IT bone could be seen entirely (posterior portion). RESULTS: A statistically significant degree of lateralization was observed at all levels in all patients. The mean lateralization rates were 15%, 26%, and 23% for the right side, and 26%, 29%, and 25% for the left side at first, second, and third levels, respectively. There was no bleeding, edema, or crusting due to the outfracture procedure in any patient. CONCLUSIONS: Our results suggest that outfracture of the IT is an effective and durable technique, which can be performed easily to enlarge the nasal airway in mild and moderate IT hypertrophies with minimal morbidity.
对于下鼻甲肥大,有多种手术治疗方式。每种方式都伴有公认的并发症,但对于最佳技术仍缺乏共识。在下鼻甲所有其他缩小手术中,下鼻甲外骨折被认为是一种微创操作。我们的目的是评估下鼻甲外骨折技术对轻、中度下鼻甲肥大患者的长期效果。
在鼻中隔成形术中对10例患者的20个下鼻甲进行外骨折。在手术前及术后9个月,利用计算机断层扫描对每位患者鼻道的3个不同水平(1)能完整看到下鼻甲骨质的第一层面(前部)、(2)上颌窦口水平(中部)、(3)能完整看到下鼻甲骨质的最后层面(后部),比较下鼻甲骨质与鼻外侧壁的距离。
所有患者在各个水平均观察到有统计学意义的外侧移位。右侧在第一、第二和第三水平的平均外侧移位率分别为15%、26%和23%,左侧分别为26%、29%和25%。所有患者均未因外骨折操作出现出血、水肿或结痂。
我们的结果表明,下鼻甲外骨折是一种有效且持久的技术,对于轻、中度下鼻甲肥大患者,该技术操作简便,能以最小的发病率扩大鼻气道。