Department of Neuroscience DNS, Otolaryngology Section, University of Padova, Via Niccolò Giustiniani 2, 35128, Padova, Italy.
Eur Arch Otorhinolaryngol. 2020 Jul;277(7):1961-1967. doi: 10.1007/s00405-020-05910-2. Epub 2020 Mar 13.
Limited approach septoplasty (LAS) follows the principle of respecting nasal structures and aims to minimize complications while ensuring proper nasal respiratory function. LAS is only applicable to selected cases of septal deviation. The present study aimed to: (1) compare short- and mid-term complications in two consecutive series of patients with the same type of septal deviation treated with LAS or classical septoplasty; and (2) examine postoperative respiratory function with active anterior rhinomanometry in the two series, and in a group of healthy, non-surgical volunteers.
The study concerned two groups of 20 consecutive patients who underwent LAS or classical septoplasty for deviation in Cottle's areas 4/5, and a control group of 11 healthy adult volunteers with no sinonasal disorders.
The mean operating time did not differ significantly between the two groups. Three patients in each group developed minor complications. In a sitting position, the mean total nasal inspiratory resistance was 0.018 and 0.019 Pa ml/s (p = 0.46) in the LAS and classical septoplasty groups, respectively, and the total expiratory resistance was 0.019 and 0.018 Pa ml/s (p = 0.30). In a supine position, the mean total nasal inspiratory resistance was 0.017 and 0.021 Pa ml/s (p = 0.05), and the total expiratory resistance was 0.017 and 0.019 Pa ml/s (p = 0.14) in the LAS and classical septoplasty groups, respectively.
In selected cases, LAS achieved much the same short- and mid-term results as classical septoplasty. The mini-invasive approach is certainly more respectful of the nasal mucosa, requiring a less extensive detachment, with consequent faster healing times and less tissue damage.
有限切开鼻中隔成形术(LAS)遵循尊重鼻腔结构的原则,旨在在确保适当的鼻腔呼吸功能的同时,尽量减少并发症。LAS 仅适用于鼻中隔偏曲的选定病例。本研究旨在:(1)比较两组接受 LAS 或经典鼻中隔成形术治疗的同一类型鼻中隔偏曲患者的短期和中期并发症;(2)在前鼻主动测压法下检查两组和一组无鼻-鼻窦疾病的健康非手术志愿者的术后呼吸功能。
本研究涉及两组 20 例连续患者,他们因 Cottle 区 4/5 的鼻中隔偏曲而行 LAS 或经典鼻中隔成形术,一组 11 例健康成年志愿者作为对照组,无鼻-鼻窦疾病。
两组的平均手术时间无显著差异。每组有 3 例患者出现轻微并发症。在坐姿下,LAS 组和经典鼻中隔成形术组的总鼻吸气阻力分别为 0.018 和 0.019 Pa ml/s(p=0.46),总呼气阻力分别为 0.019 和 0.018 Pa ml/s(p=0.30)。在仰卧位时,LAS 组和经典鼻中隔成形术组的总鼻吸气阻力分别为 0.017 和 0.021 Pa ml/s(p=0.05),总呼气阻力分别为 0.017 和 0.019 Pa ml/s(p=0.14)。
在选定的病例中,LAS 获得了与经典鼻中隔成形术几乎相同的短期和中期结果。微创方法肯定更尊重鼻黏膜,需要进行较少的广泛分离,从而导致更快的愈合时间和更少的组织损伤。