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开放式鼻中隔成形术后的臭味:黏膜松解的窦内缝合的效果。

Postoperative malodorous smell in open septorhinoplasty: the effect of intradomal suturing with mucosal release.

机构信息

Division of Otolaryngology Head & Neck Surgery, King Abdullah Specialized Children Hospital (KASCH), King Abdulaziz Medical City (KAMC), National Guard Health Affairs (NGHA), Riyadh, Saudi Arabia.

出版信息

Eur Arch Otorhinolaryngol. 2021 Mar;278(3):703-709. doi: 10.1007/s00405-020-06307-x. Epub 2020 Aug 27.

Abstract

PURPOSE

The aim of this study was to test a mucosal release method for decreasing the occurrence of malodourous smells after septorhinoplasty by preventing formation of debris pockets after surgery.

METHODS

This study included 50 adult patients from 18 to 45 years of age who underwent open septorhinoplasty from January to May 2019. Patients were divided into two groups. The first group had intradomal (transdomal) sutures without submucosal release, while the second group had mucosal release. All patients had scheduled post-op visits at 1, 2, 4, and 8 weeks and 6 months.

RESULTS

The overall postoperative rate of malodorous smell in both mucosal release and non-mucosal release patients at 2 weeks, 8 weeks and 6 months was 43.1%, 31.4% and 5.9%, respectively. Patients 36-45 years of age had a higher rate of postoperative malodorous smell with 55.6% at 2 weeks, decreasing to 33.3% at 8 weeks, and to less than 1% at 6 months. At 2 weeks after surgery, only 20% of the mucosal release group reported a malodorous smell compared to 65.4% in the non-mucosal release group. The rate was 8% at 8 weeks, and less than 1% at 6 months in the mucosal release group compared to 53.8% at 8 weeks and 11.5% at 6 months in the non-mucosal release group.

CONCLUSIONS

Utilizing absorbable polydioxanone sutures and releasing the vestibular mucosa of the LLC significantly reduced the rate of postoperative malodorous smell for septorhinoplasty patients with intradomal (transdomal) single-dome suturing.

摘要

目的

本研究旨在通过防止术后形成碎片袋,测试一种黏膜释放方法,以减少鼻中隔成形术后恶臭气味的发生。

方法

本研究纳入了 2019 年 1 月至 5 月期间接受开放式鼻中隔成形术的 50 名 18 至 45 岁的成年患者。患者分为两组。第一组为鼻中隔(跨鼻中隔)无黏膜下释放的缝合,第二组为黏膜释放。所有患者均在术后 1、2、4 和 8 周及 6 个月进行随访。

结果

在 2 周、8 周和 6 个月时,黏膜释放组和非黏膜释放组的患者术后恶臭气味的总发生率分别为 43.1%、31.4%和 5.9%。36-45 岁的患者术后恶臭气味发生率较高,2 周时为 55.6%,8 周时降至 33.3%,6 个月时降至 1%以下。术后 2 周时,黏膜释放组仅有 20%的患者报告有恶臭气味,而非黏膜释放组则有 65.4%。8 周时为 8%,6 个月时则低于 1%,而非黏膜释放组 8 周时为 53.8%,6 个月时为 11.5%。

结论

对于采用鼻中隔(跨鼻中隔)单瓣缝合的鼻中隔成形术患者,使用可吸收聚二氧杂环已酮缝线并释放 LLC 前庭黏膜可显著降低术后恶臭气味的发生率。

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