Albergo Leandro, Desio Ernesto, Revelli Velia Elena, Acosta Micaela B
Department of Otorhinolaryngology, Complejo Medico de la Policia Federal Argentina Churruca Visca, Buenos Aires, Argentina.
Facial Plast Surg. 2020 Oct;36(5):635-642. doi: 10.1055/s-0040-1713794. Epub 2020 Jul 20.
Difficulty in nasal ventilation is one of the most frequently occurring problems in otorhinolaryngology and its correct diagnosis is the key step to solve it. The dysfunctions in the valve area are a frequent cause of chronic nasal obstruction, though commonly ignored. The objective of the study is to analyze the clinical and functional outcomes in a group of patients with septal deviations and valve compromise treated with spreader graft with endonasal approach. Thirty-five patients with septal deviation with compromise of the internal nasal valve (INV; area II of Cottle), treated with spreader graft and a minimum follow-up of 12 months, were included for analysis. Patients were evaluated with video nasosinusal endoscopy, photography, the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire, and rhinomanometry (RM). Postoperative complications were recorded. The results obtained in the pre- and postoperative NOSE scores showed significant differences ( = 0.001), as also in pre- and postoperative RM tests ( < 0.001). Two complications were reported in the 35 patients; thus the complication rate in our sample was 6%. The use of spreader grafts, with endonasal approach, as nasal septum's tutors improved perpendicular septal deviations with compromise of the INV (area II), reaching an effective functional improvement in the nasal airway, with low rate of complications.
鼻通气困难是耳鼻咽喉科最常见的问题之一，正确诊断是解决该问题的关键步骤。鼻瓣区功能障碍是慢性鼻塞的常见原因，但常被忽视。本研究的目的是分析一组采用鼻内镜下撑开植骨治疗鼻中隔偏曲合并鼻瓣区受损患者的临床和功能结局。纳入35例鼻中隔偏曲合并鼻内瓣膜（INV；科特尔II区）受损且接受撑开植骨治疗、随访至少12个月的患者进行分析。采用鼻鼻窦视频内镜、摄影、鼻阻塞症状评估（NOSE）问卷和鼻阻力测量（RM）对患者进行评估。记录术后并发症。术前和术后NOSE评分结果显示有显著差异（P = 0.001），术前和术后RM测试结果也有显著差异（P < 0.）。35例患者中报告了2例并发症；因此，我们样本中的并发症发生率为6%。采用鼻内镜下撑开植骨作为鼻中隔支撑物，改善了INV（II区）受损的鼻中隔垂直偏曲，实现了鼻气道有效的功能改善且并发症发生率低。
