Zhao Ke-Qing, Pu Shi-Lei, Yu Hong-Meng
Department of Otorhinolaryngology-Head and Neck Surgery, Eye and Ear, Nose, and Throat (ENT) Hospital, Shanghai Key Clinical Disciplines of Otorhinolaryngology, Fudan University.
Department of Otorhinolaryngology-Head and Neck Surgery, Eye and Ear, Nose, and Throat (ENT) Hospital, Shanghai Key Clinical Disciplines of Otorhinolaryngology, Fudan University; Department of Otorhinolaryngology-Head and Neck Surgery, Children's Hospital of Shanghai.
J Vis Exp. 2018 Jun 20(136):57678. doi: 10.3791/57678.
Endoscopic septoplasty is a surgical procedure in otolaryngology that is commonly performed to treat nasal airway obstruction caused by nasal septal deviation. It has a long history with multiple variations. In this article, a modified endoscopic septoplasty procedure using the limited two-line resection (2LoRs) technique at the posterior and inferior junction of the cartilaginous and bony septum is presented based on embryologic and anatomic knowledge of the nasal septum and the biomechanics of cartilaginous behavior. With this procedure, the quadrangular cartilage can be preserved as much as possible, which is helpful in retaining the supporting framework and rigidness of the septum. 2LoRs has been proven effective and sound for the correction of nasal septal deviation with rare complications. This modified procedure can be applied to correct the deviated nasal septum in the absence of any external nasal deformity to improve nasal patency or to improve access to the middle meatus or to the axillary region of the middle turbinate. It may also be used to expand the indications of septoplasty to children and adolescents because of its minimally invasive approach.
内镜下鼻中隔成形术是耳鼻喉科的一种外科手术，通常用于治疗鼻中隔偏曲引起的鼻气道阻塞。它历史悠久，有多种术式。本文基于鼻中隔的胚胎学和解剖学知识以及软骨行为的生物力学，介绍了一种改良的内镜下鼻中隔成形术，该术式在软骨性鼻中隔与骨性鼻中隔的后下交界处采用有限双线切除术（2LoRs）技术。通过该手术，可尽可能保留四边形软骨，这有助于保持鼻中隔的支撑框架和硬度。2LoRs已被证明在矫正鼻中隔偏曲方面有效且可靠，并发症罕见。这种改良手术可用于在无任何鼻外部畸形的情况下矫正鼻中隔偏曲，以改善鼻腔通畅度，或改善对中鼻道或中鼻甲腋区的暴露。由于其微创方法，它还可用于将鼻中隔成形术的适应证扩展至儿童和青少年。
