Bewick J C, Buchanan M A, Frosh A C
Department of ENT, East and North Hertfordshire NHS Trust, Lister Hospital, Corey's Mill Lane, Stevenage SG1 4AB, UK.
Int J Otolaryngol. 2013;2013:734795. doi: 10.1155/2013/734795. Epub 2013 Apr 4.
Introduction. Internal nasal valve incompetence (INVI) has been treated with various surgical methods. Large, single surgeon case series are lacking, meaning that the evidence supporting a particular technique has been deficient. We present a case series using alar batten grafts to reconstruct the internal nasal valve, all performed by the senior author. Methods. Over a 7-year period, 107 patients with nasal obstruction caused by INVI underwent alar batten grafting. Preoperative assessment included the use of nasal strips to evaluate symptom improvement. Visual analogue scale (VAS) assessment of nasal blockage (NB) and quality of life (QOL) both pre- and postoperatively were performed and analysed with the Wilcoxon signed rank test. Results. Sixty-seven patients responded to both pre- and postoperative questionnaires. Ninety-one percent reported an improvement in NB and 88% an improvement in QOL. The greatest improvement was seen at 6 months (median VAS 15 mm and 88 mm resp., with a P value of <0.05 for both). Nasal strips were used preoperatively and are a useful tool in predicting patient operative success in both NB and QOL (odds ratio 2.15 and 2.58, resp.). Conclusions. Alar batten graft insertion as a single technique is a valid technique in treating INVI and produces good outcomes.
引言。鼻内瓣膜功能不全(INVI)已采用多种手术方法进行治疗。目前缺乏大型的、由单一外科医生完成的病例系列研究,这意味着支持特定技术的证据不足。我们展示了一个使用鼻翼条带移植重建鼻内瓣膜的病例系列,所有手术均由资深作者完成。方法。在7年的时间里,107例因INVI导致鼻塞的患者接受了鼻翼条带移植手术。术前评估包括使用鼻贴来评估症状改善情况。采用视觉模拟量表(VAS)对术前和术后的鼻阻塞(NB)及生活质量(QOL)进行评估,并使用Wilcoxon符号秩检验进行分析。结果。67例患者对术前和术后问卷均有回应。91%的患者报告NB有所改善,88%的患者报告QOL有所改善。最大改善出现在术后6个月(NB和QOL的VAS中位数分别为15毫米和88毫米,两者P值均<0.05)。术前使用了鼻贴,它是预测患者在NB和QOL方面手术成功的有用工具(优势比分别为2.15和2.58)。结论。鼻翼条带移植作为一种单一技术,是治疗INVI的有效技术,且效果良好。