Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A.
Laryngoscope. 2014 Jun;124(6):1290-5. doi: 10.1002/lary.24356. Epub 2013 Sep 19.
OBJECTIVES/HYPOTHESIS: 1) Study outcomes of revision septoplasty using a validated disease-specific questionnaire and a patient satisfaction survey; 2) assess the effect of surgery on the use of medication to treat nasal congestion; and 3) report on sites of persistent septal deviation identified at revision septoplasty.
Prospective, single-center outcome study of patients with symptomatic nasal obstruction and persisting septal deviation despite prior septal surgery.
The Nasal Obstruction Symptom Evaluation (NOSE) scale was administered preoperatively and at 3 and 6 months following revision surgery. Patients were also questioned regarding ease of breathing and medication use preoperatively and postoperatively, as well as satisfaction with the surgical outcome. Anatomic site(s) of residual septal deviation were recorded intraoperatively.
Thirty-nine patients completed the study. Mean NOSE scores decreased significantly from 75.9 preoperatively to 14.9 3 months after revision surgery. Mean Ease-of-Breathing scores over this interval improved from 3/10 preoperatively to 8.5/10. Both results were sustained at 6 months (P <0.0001). Patient satisfaction was very high, and many patients required less medication to treat symptoms of nasal congestion postoperatively. Deviations persisting from prior surgery most commonly involved the dorsal or caudal septum.
In patients who experience ongoing nasal obstruction with a persistent septal deviation despite prior septoplasty, revision surgery significantly improves disease-specific quality of life, results in high patient satisfaction, and may diminish the need for nasal medications postoperatively. Caudal or dorsal deflections may be more difficult to correct, leading to the need for revision surgery.
2C.
目的/假设：1）使用经过验证的疾病特异性问卷和患者满意度调查评估修正鼻中隔成形术的结果；2）评估手术对治疗鼻塞药物使用的影响；3）报告在修正鼻中隔成形术中发现的鼻中隔持续偏曲的部位。
对有症状的鼻腔阻塞且鼻中隔偏曲持续存在的患者进行前瞻性、单中心结局研究，这些患者尽管先前接受过鼻中隔手术，但仍存在这些问题。
在修正手术后的 3 个月和 6 个月，使用鼻腔阻塞症状评估量表（NOSE）进行术前和术后评估。患者还在术前和术后询问了呼吸舒适度和药物使用情况，并对手术结果的满意度进行了询问。术中记录残余鼻中隔偏曲的解剖部位。
39 例患者完成了研究。NOSE 评分从术前的 75.9 分显著下降至修正手术后 3 个月的 14.9 分。在此期间，Ease-of-Breathing 评分从术前的 3/10 分提高至 8.5/10 分。这两个结果在 6 个月时仍持续存在（P <0.0001）。患者满意度非常高，许多患者术后需要更少的药物来治疗鼻塞症状。与先前手术相比，最常见的鼻中隔偏曲残留部位是中隔的背侧或尾侧。
对于经历过持续的鼻腔阻塞和鼻中隔偏曲持续存在的患者，即使他们先前已经接受过鼻中隔成形术，修正手术也能显著改善疾病特异性生活质量，患者满意度高，并且可能减少术后对鼻腔药物的需求。尾侧或背侧的偏曲可能更难纠正，导致需要进行修正手术。
2C。
