Stähr Kerstin, Holtmann Laura, Schlüter Anke, Kaster Friederike, Oeverhaus Michael, Lang Stephan, Eckstein Anja, Mattheis Stefan
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
Department of Ophthalmology, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
Eur Arch Otorhinolaryngol. 2018 Oct;275(10):2507-2513. doi: 10.1007/s00405-018-5105-2. Epub 2018 Aug 30.
To determine the influence of anatomical changes after orbital decompression to nasal function.
We examined postoperative nasal function after orbital decompression in patients with GO in a prospective study. 25 patients were enrolled between 2014 and 2016. Sense of smell (Sniffin' Test) and nasal airflow (anterior rhinomanometry) were tested pre- and 6 weeks postoperatively. In addition, postoperative incidence of sinus infections, persistent pressure pain, and infraorbital hypoesthesia were assessed by means of a questionnaire.
The olfactory performance showed a significant increase (p < 0.05) after surgery, while the nasal airflow significantly decreased (p < 0.05). Acute sinus infection occurred in three, infraorbital sensibility disorders in eight cases within the first 6 weeks after surgery. No persistent pain was recorded.
We demonstrate that decompression of the medial orbital wall leads to a decrease in nasal airflow, whereof patients should be informed before the procedure. This is most likely due to a medialization of the medial turbinate and the prolapse of orbital content into the nasal cavity. The increase of the olfactory performance is, in our opinion, more likely due to variation within the standard deviation than to anatomical changes.
确定眼眶减压术后解剖结构变化对鼻腔功能的影响。
我们在一项前瞻性研究中检查了甲状腺相关眼病(GO)患者眼眶减压术后的鼻腔功能。2014年至2016年期间纳入了25例患者。在术前和术后6周测试嗅觉(嗅觉测试)和鼻气流(前鼻测压法)。此外,通过问卷调查评估术后鼻窦感染、持续性压痛和眶下感觉减退的发生率。
术后嗅觉表现显著提高(p<0.05),而鼻气流显著降低(p<0.05)。术后前6周内,3例发生急性鼻窦感染,8例出现眶下感觉障碍。未记录到持续性疼痛。
我们证明眼眶内侧壁减压会导致鼻气流减少,手术前应告知患者这一点。这很可能是由于中鼻甲向内侧移位以及眶内容物脱垂至鼻腔所致。我们认为,嗅觉表现的提高更可能是由于标准差范围内的变化,而非解剖结构改变。