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采用自体肋软骨鼻甲重建术成功治疗原发性萎缩性鼻炎。

Successful management of primary atrophic rhinitis by turbinate reconstruction using autologous costal cartilage.

作者信息

Park Marn Joon, Jang Yong Ju

机构信息

Departments of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Departments of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

出版信息

Auris Nasus Larynx. 2018 Jun;45(3):613-616. doi: 10.1016/j.anl.2017.06.003. Epub 2017 Jun 29.

Abstract

Initial management of primary atrophic rhinitis is conservative, with nasal ointments, saline irrigation, and antibiotics prescribed to relieve symptoms. However, in cases that show no improvement, a surgical approach is considered. Recently, many studies have reported successful surgical outcomes using various nasal implants. However, no study has reported implantation of autologous costal cartilage in PAR patients. We report here the case of a 63-year-old woman diagnosed with PAR that was intractable to medical therapy. Under general anesthesia, bilateral inferior turbinate reconstruction with autologous costal cartilage was successfully performed without any complications. One month after surgery, her symptoms improved dramatically. At the 2-year follow-up, her Sinonasal Outcome Test 25 (SNOT-25) score was 6, down from an initial score of 108. Her OMU CT showed improved sinonasal mucosal thickness and disappearance of thick mucosal secretion compared with preoperative CT image. Although this is a single case experience, it is suggested that turbinate reconstruction using autologous costal cartilage can serve as promising surgical modality for management of atrophic rhinitis.

摘要

原发性萎缩性鼻炎的初始治疗是保守的,可使用鼻用软膏、盐水冲洗和抗生素来缓解症状。然而,对于没有改善的病例,则考虑采用手术方法。最近,许多研究报告了使用各种鼻植入物取得的成功手术效果。然而,尚无研究报告在原发性萎缩性鼻炎患者中植入自体肋软骨的情况。我们在此报告一例63岁女性被诊断为原发性萎缩性鼻炎且药物治疗无效的病例。在全身麻醉下,成功地用自体肋软骨进行了双侧下鼻甲重建,无任何并发症。术后1个月,她的症状显著改善。在2年的随访中,她的鼻窦结局测试25(SNOT-25)评分从最初的108分降至6分。与术前CT图像相比,她的鼻窦CT显示鼻窦黏膜厚度改善,厚黏膜分泌物消失。尽管这只是单个病例的经验,但提示使用自体肋软骨进行鼻甲重建可作为治疗萎缩性鼻炎的一种有前景的手术方式。

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