ENT & Head and Neck Surgery Department, Petz Aladár County Teaching Hospital, Vasvári P. utca 2-4., Gyor, 9023, Hungary.
Eur Arch Otorhinolaryngol. 2010 Dec;267(12):1887-91. doi: 10.1007/s00405-010-1278-z. Epub 2010 Jun 11.
The primary aim of the present study was to investigate the relationship between the subjective sensation of nasal airflow resistance, the rhinoscopic findings and the objective measures of nasal obstruction in patients followed up after septoplasty. A further goal was to determine which of the above modalities is most suitable for assessment of the severity of nasal obstruction and which best indicates the need for surgery. 86 patients who had previously undergone septoplastic surgery were recruited. Objective and subjective measures of nasal obstruction were recorded by using active anterior rhinomanometry, rhinoscopy and a visual analogue scale. The Spearman rank order correlation model revealed a significant correlation between the VAS score and the airway resistance of the more obstructed nasal cavity (r = 0.24); furthermore, between the VAS score and rhinoscopic findings (r = 0.35). By applying the generalized linear model, we also found significant relation between the VAS score and the rhinomanometric data, and between the rhinoscopic findings and the airway resistance of the more obstructed nasal cavity (p = 0.02). The correlation between the subjective sensation of nasal airflow resistance, the rhinoscopic findings, and the rhinomanometric data proved to be significant, but weak even in the group of patients that underwent septoplasty. Every postoperative complaint should therefore be evaluated carefully. Rhinomanometry is an appropriate diagnostic tool with which to determine the measure of obstruction caused by nasal pathological factors. It is suitable for making objective the patients' complaints. Rhinoscopy, beyond the assessment of the degree of obstruction, is capable of analysis of its cause. The decision as to the need for surgery should be based on rhinoscopy, or nasal endoscopy, and can be supported by pathologically elevated resistance of the more obstructed nasal cavity.
本研究的主要目的是探讨鼻中隔成形术后患者的鼻腔主观气流阻力感、鼻镜检查结果与客观鼻腔阻塞程度之间的关系。进一步的目的是确定上述哪种方法最适合评估鼻腔阻塞的严重程度,以及哪种方法最能表明需要手术。本研究共招募了 86 例曾行鼻中隔成形术的患者。采用主动前鼻测压法、鼻镜检查和视觉模拟评分法(VAS)记录患者的鼻腔阻塞的客观和主观指标。Spearman 等级相关模型显示,VAS 评分与更阻塞侧鼻腔气道阻力(r = 0.24)之间存在显著相关性;此外,VAS 评分与鼻镜检查结果(r = 0.35)之间存在显著相关性。应用广义线性模型,我们还发现 VAS 评分与鼻测压数据之间以及鼻镜检查结果与更阻塞侧鼻腔气道阻力之间存在显著关系(p = 0.02)。鼻腔主观气流阻力、鼻镜检查结果和鼻测压数据之间的相关性虽然具有统计学意义,但即使在鼻中隔成形术后的患者中,相关性也较弱。因此,每个术后症状都应仔细评估。鼻测压法是一种合适的诊断工具,可用于确定由鼻腔病理因素引起的阻塞程度。它适用于客观评估患者的症状。鼻镜检查除了评估阻塞程度外,还能够分析其原因。是否需要手术的决定应基于鼻镜检查或鼻内镜检查,并可通过更阻塞侧鼻腔病理性升高的阻力来支持。