对面瘫患者鼻翼基底矫正术后生活质量改善的前瞻性评估。
Prospective evaluation of quality-of-life improvement after correction of the alar base in the flaccidly paralyzed face.
作者信息
Lindsay Robin W, Bhama Prabhat, Hohman Marc, Hadlock Tessa A
机构信息
Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston2Harvard Medical School, Boston, Massachusetts.
Department of Otolaryngology-Head and Neck Surgery, Madigan Army Medical Center, Tacoma, Washington.
出版信息
JAMA Facial Plast Surg. 2015 Mar-Apr;17(2):108-12. doi: 10.1001/jamafacial.2014.1295.
IMPORTANCE
Nasal valve collapse caused by facial palsy is an often overlooked but disturbing sequela of flaccid facial paralysis.
OBJECTIVE
To prospectively study the effect of fascia lata sling placement for correction of external nasal valve compromise in patients with flaccid facial paralysis, using a validated disease-specific quality-of-life outcome survey.
DESIGN, SETTING, AND PARTICIPANTS: This was a prospective study of 68 patients from March 2009 to December 2013 who underwent fascia lata sling placement for correction of external nasal valve compromise.
INTERVENTION
Fascia lata sling placement for the correction of external nasal valve compromise .
MAIN OUTCOME AND MEASURE
Nasal Obstruction Symptom Evaluation (NOSE) scale.
RESULTS
Sixty-eight disease-specific quality-of-life determinations were performed using the NOSE scale. Ratings were ascertained preoperatively and postoperatively. Sixty patients completed a NOSE scale prior to surgical intervention, and 40 completed the survey after intervention. There was a statistically significant difference in NOSE scores after fascia lata sling placement The mean preoperative NOSE score was 37.6 (27.1), and the mean postoperative score was 16.6 (17.37) (Wilcoxon signed-rank test; P < .001). All patients had improvement in their nasal obstruction, which persisted uniformly in follow-up.
CONCLUSIONS AND RELEVANCE
The nasal valve is a zone that has historically been neglected, despite the fact that a highly effective surgical solution has existed for decades. We highlight the significance of nasal valve dysfunction in patients with flaccid facial paralysis, demonstrate a quantitative benefit in disease-specific quality of life after fascia late sling placement for external nasal valve compromise, and suggest an updated treatment algorithm. This method offers a predictably successful, straightforward surgical solution to an overlooked functional problem in the patient with flaccid facial paralysis.
LEVEL OF EVIDENCE
重要性
面瘫导致的鼻瓣塌陷是弛缓性面瘫一个常被忽视但令人困扰的后遗症。
目的
使用经过验证的特定疾病生活质量结果调查，前瞻性研究阔筋膜吊带植入术对矫正弛缓性面瘫患者鼻外瓣功能不全的效果。
设计、地点和参与者：这是一项对2009年3月至2013年12月期间68例接受阔筋膜吊带植入术以矫正鼻外瓣功能不全患者的前瞻性研究。
干预措施
采用阔筋膜吊带植入术矫正鼻外瓣功能不全。
主要结局和测量指标
鼻阻塞症状评估（NOSE）量表。
结果
使用NOSE量表进行了68次特定疾病生活质量测定。在术前和术后进行评分。60例患者在手术干预前完成了NOSE量表评分，40例在干预后完成了该调查。阔筋膜吊带植入术后NOSE评分有统计学显著差异。术前平均NOSE评分为37.6（27.1），术后平均评分为16.6（17.37）（Wilcoxon符号秩检验；P < 0.001）。所有患者的鼻阻塞情况均有改善，且在随访中持续存在。
结论及相关性
尽管几十年来一直存在一种高效的手术解决方案，但鼻瓣区域在历史上一直被忽视。我们强调了鼻瓣功能障碍在弛缓性面瘫患者中的重要性，证明了阔筋膜吊带植入术治疗鼻外瓣功能不全后在特定疾病生活质量方面有量化益处，并提出了更新的治疗算法。该方法为弛缓性面瘫患者中一个被忽视的功能问题提供了一种可预测成功且直接的手术解决方案。
证据级别
4级。
Zotero 插件