Stange T, Schultz-Coulon H-J
HNO-Klinik, Lukaskrankenhaus Neuss.
Laryngorhinootologie. 2010 Mar;89(3):157-61. doi: 10.1055/s-0029-1241832. Epub 2009 Nov 12.
20 years after its first description, the bridge-flap technique according to Schultz-Coulon has proven to be the most successful method by far for the closure of nasoseptal defects. The number of nasoseptal defects being treated in Germany, and the treatment methods being used, are currently an unknown factor.
A questioning survey was sent to all 157 German ENT clinics. They were asked about the number of treatments of nasoseptal defects and the frequency of surgical techniques applied during 2007.
123 questionnaires were evaluated (return ratio=78.3%). In total, 777 nasoseptal defects were treated in Germany during 2007. 31 clinics treated no nasoseptal defects; at 71 clinics, 1-10, at 16 clinics, 11-20, and at 5 clinics, more than 30 nasoseptal defects were treated. 713 nasoseptal defects (91.8%) received surgical treatment, and 64 (8.2%) were treated by inserting a silicone button. With 556 patients (78%), the surgical closures of the nasoseptal defects took place with the help of the bridge-flap technique.
The survey data show a clear tendency towards the surgical care of nasoseptal defects at ENT clinics in Germany. In comparison to the previous school of thought that, in view of doubtful surgical results, symptomatic septal defects should be treated somewhat conservatively, a paradigm shift thereby took place. The fact that in the overwhelming majority of cases (78%), the bridge-flap technique according to Schultz-Coulon is used suggests that the favourable chances of success of this method are mainly responsible for the increasing surgical treatment of nasoseptal defects.
自首次描述以来的20年里,舒尔茨 - 库隆(Schultz-Coulon)桥瓣技术已被证明是迄今为止闭合鼻中隔缺损最成功的方法。目前,德国治疗鼻中隔缺损的数量以及所采用的治疗方法仍是未知因素。
向德国所有157家耳鼻喉科诊所发送了问卷调查。询问了他们在2007年治疗鼻中隔缺损的数量以及所应用手术技术的频率。
共评估了123份问卷(回复率 = 78.3%)。2007年德国总共治疗了777例鼻中隔缺损。31家诊所未治疗鼻中隔缺损;71家诊所治疗了1 - 10例,16家诊所治疗了11 - 20例,5家诊所治疗了超过30例鼻中隔缺损。713例鼻中隔缺损(91.8%)接受了手术治疗,64例(8.2%)通过插入硅胶纽扣进行治疗。556例患者(78%)借助桥瓣技术进行了鼻中隔缺损的手术闭合。
调查数据显示德国耳鼻喉科诊所对鼻中隔缺损进行手术治疗有明显趋势。与之前认为鉴于手术结果存疑,有症状的鼻中隔缺损应采取较为保守治疗的观点相比,发生了范式转变。绝大多数病例(78%)采用舒尔茨 - 库隆桥瓣技术这一事实表明,该方法良好的成功几率是鼻中隔缺损手术治疗增加的主要原因。