Pecorari Giancarlo, Riva Giuseppe, Bianchi Francesca Antonella, Cavallo Giovanni, Revello Francesca, Bironzo Marco, Verzè Laura, Garzaro Massimiliano, Ramieri Guglielmo
Otorhinolaryngology Division, Surgical Sciences Department, University of Turin, Turin, Italy.
Am J Rhinol Allergy. 2017 Sep 1;31(5):323-327. doi: 10.2500/ajra.2017.31.4459.
Because nasal function and shape are so closely intertwined, quantitative assessments can better define their relationship and how they are affected by septorhinoplasty.
The aim of this prospective study was to perform an analysis of the nasal airflow resistances and a three-dimensional (3D) evaluation of the soft-tissue changes after closed septorhinoplasty.
Before surgery (T0) and 6 months after closed septorhinoplasty (T1), 30 patients underwent symptoms evaluation by means of the Italian version of the Nasal Obstruction Symptom Evaluation scale, endoscopic fiberoptic nasal examination, and visual analog scale for subjective assessment of nasal obstruction. Nasal airflow resistances were investigated with active anterior active rhinomanometry. A 3D laser scanner was used to evaluate facial soft-tissues, with specific nasal points and angles.
Subjective nasal obstruction decreased. Anterior active rhinomanometry demonstrated a reduction in total inspiratory and expiratory resistances between T0 and T1 but without statistical significance. The significance was still absent after decongestion, excluding turbinate hypertrophy as a cause of failed objective amelioration of nasal resistance. Facial laser scanning showed statistically significant reduction of the superior nasal width and superior alar angle, and a weak negative correlation between the superior alar angle and nasal resistances.
The absence of objective reduction of nasal airflow resistances could be the result of concurrent surgery on nasal septum and nasal valve. In particular, the ameliorating effect on nasal airflow resistances is counterbalanced by the worsening effect of the narrowing of nasal valve.
由于鼻腔功能与形态紧密相连，定量评估能够更好地明确它们之间的关系以及鼻中隔鼻成形术对其的影响方式。
这项前瞻性研究的目的是分析闭合性鼻中隔鼻成形术后的鼻气流阻力，并对软组织变化进行三维（3D）评估。
30例患者在手术前（T0）和闭合性鼻中隔鼻成形术后6个月（T1），通过意大利语版鼻阻塞症状评估量表进行症状评估、纤维鼻内镜检查以及采用视觉模拟量表对鼻阻塞进行主观评估。采用主动前鼻测压法研究鼻气流阻力。使用三维激光扫描仪评估面部软组织，包括特定的鼻点和角度。
主观鼻阻塞减轻。主动前鼻测压显示T0和T1之间总吸气和呼气阻力降低，但无统计学意义。减充血后仍无统计学意义，排除鼻甲肥大是鼻阻力客观改善失败的原因。面部激光扫描显示鼻上宽度和鼻上鼻翼角有统计学意义的减小，且鼻上鼻翼角与鼻阻力之间存在弱负相关。
鼻气流阻力无客观降低可能是鼻中隔和鼻瓣同期手术的结果。特别是，鼻气流阻力的改善作用被鼻瓣狭窄的恶化作用所抵消。
