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内镜辅助 1 期矫正歪鼻气道功能和美学形态。

Endoscopy-Assisted 1-Stage Correction of the Crooked Nose Airway Function and Aesthetic Morphology.

机构信息

From the Departments of Plastic Surgery.

ENT, Peking University Third Hospital, Beijing, China.

出版信息

Ann Plast Surg. 2021 Mar 1;86(3S Suppl 2):S239-S243. doi: 10.1097/SAP.0000000000002615.

Abstract

OBJECTIVES

The aims of the study were to explore the application of endoscopy in the correction of septal deviation and nasal skeletal deviation in crooked nose deformity and, using multiple evaluation methods, to investigate the effect of endoscopy-assisted 1-stage surgery in restoring crooked nose airway function and aesthetic morphology.

METHODS

From March 2015 to March 2018, 45 patients with nasal septum and skeletal deviation were treated with endoscopy-assisted septoplasty simultaneously with rhinoplasty. The follow-up period was at least 8 months. Treatment effects were evaluated both objectively and subjectively using various methods.

RESULTS

All cases showed certain degree of airway function and nose morphology improvement. In patients with abnormal nasal ventilation, the volume and minimal cross-sectional area increased significantly after the surgery (t = 2.470 and 3.134, respectively, P < 0.05). External nose deviation distance measured on 3-dimensional models decreased significantly from 3.230 ± 1.661 mm to 1.997 ± 1.037 mm after the surgery (t = 3.772, P < 0.05). Patients visual analog scale score of nasal patency and nose morphology were significantly improved (t = 5.795 and 7.187, respectively, P < 0.05). Overall patient satisfaction was 100%, and no complication (nasal septal perforation, nasal cavity synechia, etc) was reported.

CONCLUSIONS

Septal deviation combined with external nose deflection can be corrected by endoscopy-assisted rhinoplasty and septoplasty simultaneously, to achieve 1-stage improvement of crooked nose morphology and nasal airway function. This approach has the advantages of minimal invasion, clear surgery vision, less pain, and shorter recover time. It has fewer complication and better outcomes and worth clinical promotion and application.

摘要

目的

本研究旨在探讨内镜在歪鼻畸形鼻中隔偏曲及鼻骨偏曲矫正中的应用,采用多种评价方法,探讨内镜辅助 1 期手术恢复歪鼻气道功能和美学形态的效果。

方法

2015 年 3 月至 2018 年 3 月,45 例鼻中隔和骨骼偏曲患者接受内镜辅助鼻中隔成形术同期鼻整形术治疗。随访时间至少 8 个月。采用多种方法客观和主观评估治疗效果。

结果

所有病例均显示出一定程度的气道功能和鼻部形态改善。在有异常鼻通气的患者中,手术后容积和最小横截面积显著增加(t=2.470 和 3.134,分别,P<0.05)。3 维模型上测量的外鼻偏斜距离从手术前的 3.230±1.661mm 显著减少到术后的 1.997±1.037mm(t=3.772,P<0.05)。患者鼻通气和鼻形态的视觉模拟评分显著改善(t=5.795 和 7.187,分别,P<0.05)。总体患者满意度为 100%,无并发症(鼻中隔穿孔、鼻腔粘连等)报告。

结论

鼻中隔偏曲合并外鼻偏斜可通过内镜辅助鼻整形术和鼻中隔成形术同时矫正,实现歪鼻形态和鼻气道功能的 1 期改善。该方法具有微创、手术视野清晰、疼痛少、恢复时间短等优点,并发症少,效果好,值得临床推广应用。

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