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鼻中隔支撑条移植术矫正鼻内鼻中隔成形术中的软骨畸形。

Septal batten graft to correct cartilaginous deformities in endonasal septoplasty.

作者信息

Wee Jee Hye, Lee Ji-Eun, Cho Sung-Woo, Jin Hong Ryul

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.

出版信息

Arch Otolaryngol Head Neck Surg. 2012 May;138(5):457-61. doi: 10.1001/archoto.2012.650.

DOI:10.1001/archoto.2012.650
PMID:22652943
Abstract

OBJECTIVE

To evaluate the usefulness of septal batten grafts to correct cartilaginous septal deformities in endonasal septoplasty.

DESIGN

Retrospective study.

SETTING

University medical center.

PATIENTS

Of 430 patients who underwent endonasal septoplasties from January 2006 to January 2011, 30 received septal batten grafts and were enrolled in the study. Twenty-eight patients were male and 2 were female.

MAIN OUTCOME MEASURES

Thirty consecutive patients received septal batten grafts and were followed up for more than 6 months. Patterns of septal deformity, materials used for batten graft, surgical results, symptom improvement, findings of acoustic rhinometry, and surgical complications were investigated.

RESULTS

Among the 30 patients, 5 were revision cases. Most of the deformities were characterized as moderate to severe degrees of curved or angulated deviations of the cartilaginous septum. The batten graft was performed with either septal cartilage (n = 21) or bony septum (n = 9). A straight septum was achieved in 90% of all procedures. Subjective symptoms of nasal obstruction were improved in all patients, as evaluated by the Nasal Obstruction Symptom Evaluation scale. Acoustic rhinometry revealed that after surgery the mean minimal cross-sectional area changed from 0.33 cm² to 0.42 cm² (P = .02) and the nasal volume from 4.71 mL to 6.28 mL (P = .02). There were no major complications, eg, septal perforation or saddle nose, and no revision surgery was needed.

CONCLUSION

Endonasal septal batten graft is a safe, useful, and effective technique to straighten moderate to severe septal cartilage deformities that are otherwise not correctable via conventional septoplasty techniques.

摘要

目的

评估鼻中隔支撑移植物在鼻内镜鼻中隔成形术中矫正软骨性鼻中隔畸形的效用。

设计

回顾性研究。

地点

大学医学中心。

患者

在2006年1月至2011年1月接受鼻内镜鼻中隔成形术的430例患者中,30例接受了鼻中隔支撑移植物并纳入本研究。28例为男性,2例为女性。

主要观察指标

连续30例患者接受鼻中隔支撑移植物并随访6个月以上。调查鼻中隔畸形模式、支撑移植物所用材料、手术结果、症状改善情况、鼻声反射测量结果及手术并发症。

结果

30例患者中,5例为翻修病例。大多数畸形表现为软骨性鼻中隔中度至重度的弯曲或成角偏斜。支撑移植物采用鼻中隔软骨(n = 21)或骨性鼻中隔(n = 9)。所有手术中90%实现了鼻中隔变直。根据鼻阻塞症状评估量表评估,所有患者的鼻阻塞主观症状均得到改善。鼻声反射测量显示,术后平均最小横截面积从0.33 cm²变为0.42 cm²(P = .02),鼻腔容积从4.71 mL变为6.28 mL(P = .02)。未出现重大并发症,如鼻中隔穿孔或鞍鼻,也无需翻修手术。

结论

鼻内镜鼻中隔支撑移植物是一种安全、有用且有效的技术,可矫正中度至重度鼻中隔软骨畸形,而这些畸形用传统鼻中隔成形术技术无法矫正。

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