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鼻中隔手术后薄硅胶鼻中隔夹板的实际作用。

Objective usefulness of thin silastic septal splints after septal surgery.

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.

出版信息

Am J Rhinol Allergy. 2011 May-Jun;25(3):182-5. doi: 10.2500/ajra.2011.25.3584.

Abstract

BACKGROUND

Silastic splints have been used as effective tools for septal support, avoiding adhesion, and mucosal healing after septal surgery. Furthermore, although many surgeons insert septal splints, no well-designed trials exist to support their use. A randomized double-blinded controlled trial was performed.

METHODS

We recruited 40 subjects who had undergone septoplasty only without sinus surgery or turbinoplasty. A silastic septal splint was inserted in one side of the nasal cavity at the end of each septoplasty, with the other side serving as a control. The splint side and control side were randomly selected. Nasal discomfort score (10-point scale) and mucosal status (grades 1-4) were surveyed in a blinded setting on postoperative days 7 and 14.

RESULTS

Forty of 83 subjects fulfilled the enrollment criteria. On the 7th postoperative day there was no significant difference in nasal discomfort between the splint and control sides (6.2 ± 1.28 and 5.7 ± 1.27, respectively; p = 0.116), but the mucosal status was better on the splint side than on the control side (1.5 ± 0.51 and 2.5 ± 0.85; p < 0.001). At 14 days postoperatively, the symptom score (2.7 ± 1.06 versus 3.8 ± 1.25; p < 0.001) and mucosal status (1.5 ± 0.55 versus 1.9 ± 0.68; p = 0.013) were significantly better on the splint side compared with the control side.

CONCLUSION

Insertion of a silastic septal splint after septal surgery should be accepted as a routine procedure.

摘要

背景

硅橡胶夹板已被用作鼻中隔支撑、避免粘连和鼻中隔手术后黏膜愈合的有效工具。此外,尽管许多外科医生会插入鼻中隔夹板,但没有设计良好的试验来支持其使用。本研究进行了一项随机双盲对照试验。

方法

我们招募了 40 名仅接受鼻中隔成形术而未接受鼻窦手术或鼻甲切除术的患者。在每例鼻中隔成形术结束时,将硅橡胶鼻中隔夹板插入鼻腔的一侧,另一侧作为对照。夹板侧和对照侧随机选择。在盲法环境下,于术后第 7 天和第 14 天调查鼻腔不适评分(10 分制)和黏膜状况(1-4 级)。

结果

83 例患者中有 40 例符合入组标准。术后第 7 天,夹板侧和对照侧的鼻腔不适程度无显著差异(分别为 6.2 ± 1.28 和 5.7 ± 1.27;p = 0.116),但夹板侧的黏膜状况优于对照侧(分别为 1.5 ± 0.51 和 2.5 ± 0.85;p < 0.001)。术后 14 天,症状评分(2.7 ± 1.06 与 3.8 ± 1.25;p < 0.001)和黏膜状况(1.5 ± 0.55 与 1.9 ± 0.68;p = 0.013)在夹板侧均显著优于对照侧。

结论

鼻中隔手术后插入硅橡胶鼻中隔夹板应被视为常规操作。

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