Ross Mobley Steven, Long Jennifer
Salt Lake City, Utah From Mobley MD Facial Plastic & Reconstructive Surgery, PLLC.
Plast Reconstr Surg. 2016 Jan;137(1):151e-163e. doi: 10.1097/PRS.0000000000001885.
It is well recognized that the standard septoplasty approach, in patients with severe septal deformities, may be less than adequate to address all portions of the deviated septum. The extracorporeal septoplasty technique is an alternative to the other common approaches in these more severe cases. In this study, the authors investigate functional outcomes of the standard approach. The authors use the validated Nasal Obstruction Symptom Evaluation score, before and after surgery, to quantify symptom improvement and confirm the validity and usefulness of this method in treating severe septal deviation.
A retrospective collection of clinical data was performed on all patients undergoing extracorporeal septoplasty in a 28-month period from January of 2010 through May of 2013. Fifty-five patients were identified. Demographic information, previous surgical history, and complication status were collected. The main outcome measured was functional outcome identified from preoperative and postoperative Nasal Obstruction Symptom Evaluation scores. Collaboration occurred with the study design and biostatistics center for statistical analysis.
The median preoperative and postoperative Nasal Obstruction Symptom Evaluation scores were 14.5 (interquartile range, 11.0 to 16.0) and 3.0 (interquartile range, 1.0 to 5.0), respectively. The median change between preoperative and postoperative scores was a decrease of 9.0 (interquartile range, 25.0 to 47.5). It was a statistically significant difference with (p < 0.0001 (Wilcoxon signed rank test).
Extracorporeal septoplasty is an important surgical option for repair of the severely deviated nasal septum. This study shows significant improvements in functional outcomes following this procedure, as shown by notable improvements in the validated Nasal Obstruction Symptom Evaluation score after extracorporeal septoplasty surgery.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
众所周知,对于严重鼻中隔畸形患者,标准鼻中隔成形术可能不足以处理鼻中隔偏曲的所有部位。在这些更严重的病例中,体外鼻中隔成形术是其他常见方法的一种替代方案。在本研究中,作者调查了标准方法的功能结果。作者在手术前后使用经过验证的鼻阻塞症状评估评分来量化症状改善情况,并证实该方法在治疗严重鼻中隔偏曲中的有效性和实用性。
对2010年1月至2013年5月的28个月期间接受体外鼻中隔成形术的所有患者进行临床数据的回顾性收集。共确定了55例患者。收集了人口统计学信息、既往手术史和并发症情况。主要测量结果是根据术前和术后鼻阻塞症状评估评分确定的功能结果。与研究设计和生物统计学中心合作进行统计分析。
术前和术后鼻阻塞症状评估评分的中位数分别为14.5(四分位间距,11.0至16.0)和3.0(四分位间距,1.0至5.0)。术前和术后评分的中位数变化为降低9.0(四分位间距,25.0至47.5)。差异具有统计学意义(p < 0.0001,Wilcoxon符号秩检验)。
体外鼻中隔成形术是修复严重鼻中隔偏曲的重要手术选择。本研究表明,该手术后功能结果有显著改善,体外鼻中隔成形术后经过验证的鼻阻塞症状评估评分有明显改善即证明了这一点。
临床问题/证据级别:治疗性,IV级。