Bassam Wameedh Al, Bhargava Deepa, Al-Abri Rashid
Department of ENT, Sultan Qaboos University Hospital, Sultanate of Oman.
Oman Med J. 2012 Jan;27(1):60-2. doi: 10.5001/omj.2012.13.
This report presents a novel style of placing nasal stents. Patients undergoing surgical procedures in the region of nasal vestibule and nasal valves are at risk of developing vestibular stenosis and lifelong problems with the external and internal nasal valves; sequels of the repair. The objective of the report is to demonstrate a simple and successful method of an inverted V- Stent placement to prevent potential complication of vestibular stenosis and nasal valve compromise later in life. Following a fall on a sharp edge of a metallic bed, a sixteen month old child with a deep lacerated nasal wound extending from the collumellar base toward the tip of the nose underwent surgical exploration and repair of the nasal vestibule and nasal cavity. A soft silicone stent fashioned as inverted V was placed bilaterally. The child made a remarkable recovery with no evidence of vestibular stenosis or nasal valve abnormalities. In patients with nasal trauma involving the nasal vestibule and internal and external nasal valves stent placement avoids sequels, adhesions, contractures, synechia vestibular stenosis and fibrosis involving these anatomical structures. The advantages of the described V- stents over the traditional readymade ridged nasal stents, tubing's and composite aural grafts are: a) technical simplicity of use, b) safety, c) less morbidity, d) more comfortable, and e) economical. To our knowledge, this is the first report of such a stent for prevention of vestibular stenosis and preserving nasal valves.
本报告介绍了一种新型的鼻支架放置方式。在鼻前庭和鼻瓣膜区域接受外科手术的患者有发生前庭狭窄以及鼻内外瓣膜出现终身问题的风险，这些都是修复手术的后遗症。本报告的目的是展示一种简单且成功的倒V形支架放置方法，以预防后期生活中前庭狭窄和鼻瓣膜受损的潜在并发症。一名16个月大的儿童在金属床的尖锐边缘摔倒后，鼻外伤严重，有一道从鼻小柱基部延伸至鼻尖的深部撕裂伤口，接受了鼻前庭和鼻腔的手术探查及修复。双侧放置了一个制成倒V形的柔软硅胶支架。患儿恢复情况良好，没有前庭狭窄或鼻瓣膜异常的迹象。对于涉及鼻前庭以及鼻内外瓣膜的鼻外伤患者，支架置入可避免这些解剖结构出现后遗症、粘连、挛缩、前庭狭窄粘连和纤维化。所述V形支架相较于传统的现成带棱鼻支架、管状物和复合耳移植的优势在于：a) 使用技术简单；b) 安全；c) 发病率较低；d) 更舒适；e) 经济。据我们所知，这是关于此类用于预防前庭狭窄和保护鼻瓣膜的支架的首次报告。
