Rettinger G, Lindemann K, Ashoor M, Scheithauer M, Sommer F, Lindemann J
Universität Ulm, HNO-Klinik, Ulm, Germany.
Laryngorhinootologie. 2011 Aug;90(8):471-5. doi: 10.1055/s-0031-1280840. Epub 2011 Aug 1.
Synechia formation between the middle turbinate (MT) and the lateral nasal wall is a common postoperative complication in endoscopic sinus surgery (ESS) often resulting in revision surgery. To keep the middle meatus open several procedures were described in order to medialise the MT. Long term results of these techniques are missing. The purpose of the study was to evaluate the long term results of fixing the heads of the MT to the septum by a resorbable septal-turbinate-suture (STS).
17 patients were included in the retrospective study. All patients underwent ESS with STS because of chronic rhinosinusitis with (8) and without polyps (9). The median follow-up was 81 months (range, 36-105 months). In a total 34 nasal cavities were postoperatively examined by endoscopy. Additionally, rhinomanometry and olfaction test were performed.
The MT was found in a central position in between septum and lateral wall in 10 nasal cavities (30 % ), in a more medial position in 24 (70 % ) and none in a lateral position. Only 2 patients presented unilateral synechia to the lateral wall and one unilateral to the septum.
Synechia of the MT to the lateral nasal wall in ESS can be effectively avoided by a STS. The long term results showed that STS maintains the MT in a medial position with a free middle meatus without impairing the olfactory function.
中鼻甲(MT)与鼻外侧壁之间形成粘连是鼻内镜鼻窦手术(ESS)常见的术后并发症,常导致再次手术。为保持中鼻道通畅,已描述了多种使中鼻甲向内侧移位的手术方法。这些技术的长期效果尚不清楚。本研究的目的是评估通过可吸收鼻中隔-鼻甲缝合术(STS)将中鼻甲头部固定于鼻中隔的长期效果。
本回顾性研究纳入了17例患者。所有患者因慢性鼻窦炎伴(8例)或不伴鼻息肉(9例)接受了ESS联合STS手术。中位随访时间为81个月(范围36 - 105个月)。术后共对34个鼻腔进行了内镜检查。此外,还进行了鼻阻力测量和嗅觉测试。
10个鼻腔(30%)的中鼻甲位于鼻中隔与外侧壁之间的中央位置,24个(70%)位于更内侧位置,无一例位于外侧位置。仅2例患者出现中鼻甲与外侧壁的单侧粘连,1例出现与鼻中隔的单侧粘连。
ESS中,STS可有效避免中鼻甲与鼻外侧壁粘连。长期结果表明,STS可使中鼻甲保持在内侧位置,中鼻道通畅,且不损害嗅觉功能。