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内镜下鼻中隔成形术与传统鼻中隔成形术的比较:276 例患者的客观/主观数据。

Endoscopic versus conventional septoplasty: objective/subjective data on 276 patients.

机构信息

ENT Division, University of Eastern Piedmont, Novara, Italy.

ENT Division, Santa Croce Hospital, Moncalieri, Italy.

出版信息

Eur Arch Otorhinolaryngol. 2019 Jun;276(6):1707-1711. doi: 10.1007/s00405-019-05393-w. Epub 2019 Mar 20.

Abstract

PURPOSE

Endoscopic approach represents a valid alternative to conventional septoplasty. The aim of this study is to analyze the objective and subjective data on 276 patients, who underwent traditional (147) or endoscopic (129) septoplasty.

METHODS

This is a prospective observational study on 276 consecutive patients affected by deviated nasal septum (DNS), who underwent isolated septoplasty between 2011 and 2018. 147 of them were treated using an "open" approach, while 129 were treated with an endoscopic approach. The two groups were compared 3 months after surgery: the objective results (complications such as bleeding, hematoma, pain, synechiae, septal tears and incomplete correction), objective (rhinomanometric data) and subjective measurements (NOSE questionnaires).

RESULTS

Both techniques are effective in decreasing nasal obstruction and discharge. Complications such as pain, synechiae, early postoperative bleeding, septal tears and incomplete correction are less frequent in the endoscopic group (p < 0.05). The rhinomanometric analysis reveal improvement in both groups without statistical differences. Subjective questionnaires show a good symptoms relief with an improved quality of life in all 276 patients without statistical difference between the two gropus.

CONCLUSIONS

Both techniques are effective in reducing nasal obstruction and related symptoms with fewer overall complications in the endoscopic approach. The endoscope provides improved field of view, less mucosal damages and a more anatomic dissection. Finally, such approach can be a valuable teaching tool for assistants, residents and students.

摘要

目的

内镜方法是传统鼻中隔成形术的有效替代方法。本研究旨在分析 276 例接受传统(147 例)或内镜(129 例)鼻中隔成形术患者的客观和主观数据。

方法

这是一项对 276 例鼻中隔偏曲(DNS)连续患者进行的前瞻性观察研究,这些患者在 2011 年至 2018 年间接受了单纯鼻中隔成形术。其中 147 例采用“开放式”方法治疗,129 例采用内镜方法治疗。两组患者在术后 3 个月进行比较:客观结果(如出血、血肿、疼痛、粘连、鼻中隔撕裂和矫正不完全等并发症)、客观(鼻阻力计数据)和主观测量(NOSE 问卷)。

结果

两种技术都能有效减轻鼻塞和流涕。内镜组疼痛、粘连、术后早期出血、鼻中隔撕裂和矫正不完全等并发症发生率较低(p<0.05)。鼻阻力计分析显示两组均有改善,但无统计学差异。主观问卷显示所有 276 例患者症状均有明显缓解,生活质量均有改善,两组间无统计学差异。

结论

两种技术都能有效减轻鼻塞和相关症状,内镜方法总体并发症较少。内镜提供了更好的视野、较少的粘膜损伤和更精确的解剖分离。最后,这种方法可以成为助手、住院医师和学生的有价值的教学工具。

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