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三维计算机断层扫描重建测量鼻中隔偏曲的变形率及其在鼻中隔成形术内镜手术中的应用

Measurement of deformation rate in nasal septum deviation by three-dimensional computer tomography reconstruction and its application in nasal septoplasty endoscopic surgery.

作者信息

Yang Gui, Zhao Hailiang, Wang Peng, Han Xiaodong, Zao Xinyu, Liu Zhixian, Qiu Shuqi, Liu Zhiqiang

机构信息

Rhinology Department, Longgang ENT Hospital, Shenzhen, Guangdong 518172, P.R. China.

Immunology Research Laboratory, Longgang ENT Hospital, Shenzhen, Guangdong 518172, P.R. China.

出版信息

Exp Ther Med. 2017 Aug;14(2):1519-1525. doi: 10.3892/etm.2017.4644. Epub 2017 Jun 22.

Abstract

Nasal septum deviation (NSD) typically occurs following otorhinolaryngologic surgery. However, there is a lack of biomechanical parameters able to accurately evaluate the severity of NSD. The present study aimed to determine whether the deformation rate (DR) is associated with visual analogue scale (VAS) and nasal airway resistance (NAR), and to evaluate the application of DR measurements in nasal septoplasty endoscopic surgery. In the present clinical trial, a total of 30 patients with NSD were enrolled, and DRs were calculated prior to surgery by three dimensional computer tomography (3D-CT) reconstruction techniques combined with mechanical analysis. The distribution of stress lines at the nasal septum deviation site was evaluated prior to operation. Following nasal septoplasty endoscopic surgery, pre and postoperation scores for VAS and NAR were compared. The results demonstrated that DR was significantly correlated with preoperational NAR (r=0.534) and VAS scores (r=0.397). According to preoperative CT measurements of NSD, DR and biomechanical properties, selective excision was performed to remove core areas of stress. It was observed that postoperative DR, NAR and VAS scores were significantly lower (all P<0.01) than those measured preoperation. Furthermore, over a follow-up period of 3 months, 23 cases (73.1%) were cured and 7 cases (23.3%) exhibited improvements. These results indicate that preoperative measurement of septum DR by 3D-CT reconstruction techniques may be important in determining the specific surgical approach of nasal septoplasty required.

摘要

鼻中隔偏曲(NSD)通常发生在耳鼻咽喉科手术后。然而,目前缺乏能够准确评估鼻中隔偏曲严重程度的生物力学参数。本研究旨在确定变形率(DR)是否与视觉模拟评分法(VAS)和鼻气道阻力(NAR)相关,并评估DR测量在鼻中隔成形术内镜手术中的应用。在本临床试验中,共纳入30例鼻中隔偏曲患者,术前通过三维计算机断层扫描(3D-CT)重建技术结合力学分析计算DR。术前评估鼻中隔偏曲部位应力线的分布。在鼻中隔成形术内镜手术后,比较VAS和NAR的术前和术后评分。结果表明,DR与术前NAR(r=0.534)和VAS评分(r=0.397)显著相关。根据术前鼻中隔偏曲的CT测量、DR和生物力学特性,进行选择性切除以去除应力核心区域。观察到术后DR、NAR和VAS评分均显著低于术前测量值(均P<0.01)。此外,在3个月的随访期内,23例(73.1%)治愈,7例(23.3%)病情改善。这些结果表明,术前通过3D-CT重建技术测量鼻中隔DR可能对确定所需鼻中隔成形术的具体手术方法很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae99/5526204/6574cf450530/etm-14-02-1519-g00.jpg

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