Cingi Cemal, Muluk Nuray Bayar, Ulusoy Seckin, Lopatin Andrey, Şahin Ethem, Passali Desiderio, Bellussi Luisa, Atilla Huntürk, Hanci Deniz, Altıntoprak Niyazi, Rusetski Yuri, Sarafoleanu Codrut, Mladina Ranko, Kalogjera Livije, Manea Claudiu
Department for ORL Head and Neck Surgery, Osmangazi University, Faculty of Medicine, Eskisehir, Turkey.
Am J Rhinol Allergy. 2016 Mar-Apr;30(2):e42-7. doi: 10.2500/ajra.2016.30.4289.
Physicians have long had concerns about the potential harmful effects of pediatric septoplasties on the nasoseptal growth process because septal cartilage is important for the growth and development of the face.
In this review article, pediatric septoplasty and its indications are discussed, together with a literature survey. In addition, overviews of development of the nasal skeleton from neonate to adult, nasal growth, and cartilaginous septum are presented. Important issues and comments on pediatric septoplasties are provided.
During septoplasty procedures, elevation of the mucoperichondrium unilaterally or bilaterally does not negatively affect growth of the face. Stabilization of the septum may be easier when mucosal elevation is performed unilaterally. The nasal floor mucosa should not be elevated so to avoid damage to the incisive nerves. Corrections and limited excisions may be done from the cartilaginous septum. Separation of the septal cartilage from the perpendicular plate, especially at the dorsal part, should not be performed because this area is important for the length and height of the nasal septum and nasal dorsum. Incisions or excisions should not be performed through the growing and supporting zones, especially at the sphenoethmoid dorsal zone.
If there are severe breathing problems related to the septal deviation, septoplasty should be performed. In the majority of cases, septal surgery may be conducted in 6-year-old children. However, if necessary, septal surgery may be performed in younger children and even at birth.
长期以来，医生一直担心小儿鼻中隔成形术对鼻中隔生长过程可能产生的有害影响，因为鼻中隔软骨对面部的生长发育很重要。
在这篇综述文章中，讨论了小儿鼻中隔成形术及其适应症，并进行了文献调查。此外，还介绍了从新生儿到成人鼻骨架的发育、鼻腔生长和鼻中隔软骨的概述。提供了关于小儿鼻中隔成形术的重要问题和评论。
在鼻中隔成形术过程中，单侧或双侧掀起黏骨膜不会对面部生长产生负面影响。单侧进行黏膜掀起时，鼻中隔的固定可能更容易。不应掀起鼻底黏膜，以免损伤切牙神经。可对鼻中隔软骨进行矫正和有限切除。不应将鼻中隔软骨与垂直板分离，尤其是在背侧部分，因为该区域对鼻中隔和鼻背的长度和高度很重要。不应在生长和支撑区域进行切口或切除，尤其是在蝶筛背侧区域。
如果存在与鼻中隔偏曲相关的严重呼吸问题，应进行鼻中隔成形术。在大多数情况下，6岁儿童可进行鼻中隔手术。然而，如有必要，更小的儿童甚至在出生时也可进行鼻中隔手术。
