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鼻中隔成形术有无鼻腔填塞的比较及文献综述

Comparison of septoplasty with and without nasal packing and review of literature.

作者信息

Mane Rajashri S, Patil Balasaheb, Mohite Anjana

机构信息

D. Y. Patil Medical College and Hospital, 946, B Ward, Tembe Road, Kadamwadi, Kolhapur, Maharashtra 416002 India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2013 Aug;65(Suppl 2):406-8. doi: 10.1007/s12070-013-0626-x. Epub 2013 Feb 8.

Abstract

Septoplasty is routinely performed for symptomatic deviated nasal septum. The most unpleasant part of this procedure is the pain during removal of nasal pack. The objective of this study was to compare the results of septoplasty with and without post-operative nasal packing and thereby assess the necessity of nasal packing after septoplasty. This descriptive study was carried out in ENT Department of D.Y. Patil Hospital, Kolhapur. 50 patients between the age groups of 18-50 years, having symptomatic deviated septum were selected. Out of which 25 patients underwent septoplasty with packing and 25 patients underwent septoplasty without packing with quilting sutures taken on the septum. Patients who underwent septoplasty without packing, experienced less pain and bleeding was minimal. Only one patient developed septal hematoma postoperatively. All the patients were satisfied at the end of 3 months. Simple DNS can be safely treated with septoplasty without Anterior Nasal Packing and by taking Quilting sutures on the septum. The sutures are also useful for closing any inadvertent tears of the septal mucosa and providing additional support for the cartilage pieces retained in septoplasty. Nasal packing should be should be reserved only for the patients with increased risk of bleeding.

摘要

鼻中隔成形术通常用于治疗有症状的鼻中隔偏曲。该手术最令人不适的部分是取出鼻腔填塞物时的疼痛。本研究的目的是比较鼻中隔成形术术后使用和不使用鼻腔填塞的结果,从而评估鼻中隔成形术后鼻腔填塞的必要性。这项描述性研究在科尔哈普尔的D.Y.帕蒂尔医院耳鼻喉科进行。选取了50名年龄在18至50岁之间、有症状性鼻中隔偏曲的患者。其中25例患者接受了带填塞物的鼻中隔成形术,25例患者接受了不带填塞物的鼻中隔成形术,鼻中隔采用褥式缝合。未进行鼻腔填塞的鼻中隔成形术患者疼痛较轻,出血极少。术后仅1例患者出现鼻中隔血肿。所有患者在3个月后均感到满意。单纯性鼻中隔偏曲可通过不进行前鼻孔填塞的鼻中隔成形术并在鼻中隔上采用褥式缝合安全治疗。这些缝线也有助于闭合鼻中隔黏膜的任何意外撕裂,并为鼻中隔成形术中保留的软骨片提供额外支撑。鼻腔填塞应仅保留给出血风险增加的患者。

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