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下鼻甲连续缝合在鼻中隔偏曲或不偏曲慢性肥厚性鼻炎手术中的应用。

Application of continuous suture of inferior turbinate in surgery for chronic hypertrophic rhinitis with or without nasal septum deviation.

机构信息

Department of Otolaryngology Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China.

Research Institute of Otolaryngology, Nanjing, China.

出版信息

Eur Arch Otorhinolaryngol. 2020 Apr;277(4):1089-1094. doi: 10.1007/s00405-020-05797-z. Epub 2020 Feb 4.

Abstract

PURPOSE

To explore the application value of continuous suture of the inferior turbinate in inferior turbinate submucosal bone resection.

METHODS

Twenty patients with chronic hypertrophic rhinitis with or without nasal septum deviation underwent inferior turbinate submucosal bone resection with or without septoplasty. The inferior turbinate was continuously sutured with or without nasal septum suture after surgery. The nasal cavity was not packed. The postoperative clinical outcome was evaluated using visual analog scales (VASs), saccharin test, nasal endoscopy, and nasal resistance test. Postoperative complications were recorded.

RESULTS

All 20 endoscopic surgeries were successfully performed. One day after surgery, the VAS scores of nasal pain (1.3 ± 0.5), headache (0.8 ± 0.4), tearing (0.3 ± 0.3), and bleeding (0.3 ± 0.3) in patients were low; 1 week after surgery, the nasal mucociliary transport time was not significantly prolonged compared to that before surgery (P > 0.05); 1 month after surgery, the symptoms of nasal congestion had improved significantly, as the VAS score for nasal congestion was lower than that before surgery (P < 0.05); the volume of the hypertrophied inferior turbinate of all patients was reduced, the mucous membrane was smooth and rosy, the nasal septum was centrally located, and the total nasal resistance values at 150 Pa pressure had returned to the normal reference range (0.282 ± 0.103 Pa/cm/s); no complications such as bleeding, nasal infection, nasal dryness, and olfactory disorders occurred.

CONCLUSION

After inferior turbinate submucosal bone resection with or without septoplasty, inferior turbinate continuous suture with or without nasal septum suture instead of nasal packing can significantly improve postoperative discomfort, improve nasal ventilation, protect nasal function, and accelerate postoperative recovery.

摘要

目的

探讨下鼻甲黏膜下骨切除术中连续缝合下鼻甲的应用价值。

方法

20 例慢性肥厚性鼻炎伴或不伴鼻中隔偏曲患者行下鼻甲黏膜下骨切除术或鼻中隔成形术。术后连续缝合或不缝合下鼻甲,不填塞鼻腔。采用视觉模拟评分(VAS)、糖精试验、鼻内镜和鼻阻力测试评估术后临床疗效,记录术后并发症。

结果

20 例内镜手术均顺利完成。术后 1 天,患者的鼻部疼痛(1.3±0.5)、头痛(0.8±0.4)、流泪(0.3±0.3)和出血(0.3±0.3)VAS 评分较低;术后 1 周,与术前相比,鼻黏膜纤毛传输时间无明显延长(P>0.05);术后 1 个月,鼻塞症状明显改善,鼻塞 VAS 评分低于术前(P<0.05);所有患者的下鼻甲体积均缩小,黏膜光滑红润,鼻中隔居中,150 Pa 压力下总鼻阻力值恢复至正常参考范围(0.282±0.103 Pa/cm/s);无出血、感染、鼻腔干燥、嗅觉障碍等并发症发生。

结论

下鼻甲黏膜下骨切除术后,连续缝合或不缝合下鼻甲,不填塞鼻腔,可明显减轻术后不适,改善鼻腔通气,保护鼻腔功能,促进术后恢复。

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