Scheithauer Marc Oliver
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, Ulm, Germany.
GMS Curr Top Otorhinolaryngol Head Neck Surg. 2010;9:Doc03. doi: 10.3205/cto000067. Epub 2011 Apr 27.
Surgical therapy of the inferior and/or middle turbinate is indicated when conservative treatment options have failed. The desired goal is a reduction of the soft tissue volume of the turbinates regarding the individual anatomic findings, whilst simultaneously conserving as much mucosa as possible. As the turbinates serve as a functional entity within the nose, they ensure climatisation, humidification and cleaning of the inhaled air. Thus free nasal breathing means a decent quality of life, as well.Regarding the multitude of different surgical techniques, we confirm that no ideal standard technique for turbinate reduction has been developed so far. Moreover, there is a lack of prospective and comparable long-term studies, which makes it difficult to recommend evidence-based surgical techniques. However, the anterior turbinoplasty seems to fulfil the preconditions of limited tissue reduction and mucosa-preservation, and therefore it is the method of choice today.Radical resection of the turbinates may lead to severe functional disturbances developing a secondary atrophic rhinitis. The "empty nose" syndrome is a specific entity within the secondary atrophic rhinitis where intranasal changes in airflow result in disturbed climatisation and also interfere with pulmonary function. Results deriving from an actual in vivo study of climatisation and airflow in "empty nose" patients are presented.
当保守治疗无效时，可考虑对下鼻甲和/或中鼻甲进行手术治疗。理想的目标是根据个体解剖结构，减少鼻甲的软组织体积，同时尽可能保留更多的黏膜。由于鼻甲在鼻腔内作为一个功能实体，它们确保吸入空气的温化、加湿和清洁。因此，通畅的鼻腔呼吸也意味着良好的生活质量。鉴于存在多种不同的手术技术，我们确认目前尚未开发出理想的标准下鼻甲缩小技术。此外，缺乏前瞻性和可比较的长期研究，这使得难以推荐基于证据的手术技术。然而，前鼻甲骨成形术似乎满足了组织减少有限和保留黏膜的前提条件，因此它是当今的首选方法。鼻甲的根治性切除可能导致严重的功能障碍，进而发展为继发性萎缩性鼻炎。“空鼻症”综合征是继发性萎缩性鼻炎中的一种特殊情况，鼻腔内气流的变化会导致温化功能紊乱，并干扰肺功能。本文展示了一项关于“空鼻症”患者温化和气流的实际体内研究结果。
