Ross E E, Anari S
Department of ENT,Health Education West Midlands,Birmingham,UK.
Department of ENT,Heart of England NHS Foundation Trust,Birmingham,UK.
J Laryngol Otol. 2018 Jul;132(7):591-595. doi: 10.1017/S002221511800035X. Epub 2018 Jun 11.
Procedures of limited clinical value require pre-authorisation in the National Health Service, of which rhinoplasty and septorhinoplasty are two such operations. This study surveyed clinical commissioning groups within England to document the variable eligibility criteria for rhinoplasty and septorhinoplasty.
In February 2016, a letter was sent to 209 clinical commissioning groups requesting their rhinoplasty and septorhinoplasty commissioning criteria.
A total of 200 clinical commissioning groups responded. Although 89.5 per cent allow septorhinoplasty in the presence of nasal obstruction, further criteria, such as documented health problems resulting from nasal blockage, severe functional impairment or a specific percentage of blockage, must be shown for septorhinoplasty to be authorised by most of the clinical commissioning groups.
There is great variation within individual clinical commissioning groups in England regarding the criteria for septorhinoplasty and rhinoplasty. Some criteria seem not to be clinically relevant and difficult to demonstrate. It is recommended that the guidelines are reviewed and harmonised nationally in future revisions.
在国民医疗服务体系中，临床价值有限的手术需要预先批准，鼻整形术和鼻中隔鼻整形术就是这样的两种手术。本研究对英格兰境内的临床委托小组进行了调查，以记录鼻整形术和鼻中隔鼻整形术的不同资格标准。
2016年2月，向209个临床委托小组发送了一封信，询问他们的鼻整形术和鼻中隔鼻整形术委托标准。
共有200个临床委托小组做出了回应。尽管89.5%的小组在存在鼻塞的情况下允许进行鼻中隔鼻整形术，但大多数临床委托小组要求，必须有因鼻阻塞导致的记录在案的健康问题、严重功能障碍或特定百分比的阻塞等进一步标准，鼻中隔鼻整形术才能获得批准。
英格兰各临床委托小组在鼻中隔鼻整形术和鼻整形术的标准方面存在很大差异。一些标准似乎与临床无关且难以证明。建议在未来修订中对指南进行全国范围内的审查和统一。
