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手术缓解鼻阻塞:一位资深外科医生为 366 名患者实施手术的结果。

Surgery to relieve nasal obstruction: outcome for 366 patients operated on by one senior surgeon.

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska University Hospital, Sahlgrenska Academy, University of Gothenburg, Gröna Stråket 9, 413 45, Gothenburg, Sweden.

Agro ENT, Asker, Norway.

出版信息

Eur Arch Otorhinolaryngol. 2021 Oct;278(10):3867-3875. doi: 10.1007/s00405-021-06696-7. Epub 2021 Feb 23.

Abstract

BACKGROUND

Studies of patient-rated outcome in septoplasty and turbinoplasty most frequently involve several surgeons with varying surgical skills, techniques and experience. The aim of the present study was to evaluate outcome based on one experienced surgeon.

METHODS

Three hundred and sixty-six consecutive patients referred for nasal obstruction were included. All the patients were examined with nasal endoscopy before and after decongestion, they filled out a nose VAS and rated their overall general health before and three to six months after surgery. The patients underwent septoplasty, septoplasty plus turbinoplasty or turbinoplasty.

RESULTS

The mean nose VAS for nasal obstruction (0-100) preoperatively was 64.7 for all patients. Patients undergoing septoplasty (n = 159) were younger than patients undergoing septoplasty + turbinoplasty (n = 79) or patients undergoing turbinoplasty alone (n = 128). The nose VAS for nasal obstruction improved significantly in all three groups and 25% had a normal nose VAS after surgery in the septoplasty and septoplasty + turbinoplasty groups compared to only 8% in the turbinoplasty alone group. There was no significant difference in the improvement in nasal obstruction between septoplasty and septoplasty + turbinoplasty, but the septoplasty + turbinoplasty group experienced a significantly greater improvement in general health.

CONCLUSIONS

In 366 patients operated on by one experienced surgeon, septoplasty and septoplasty + turbinoplasty were more effective at relieving nasal obstruction than turbinoplasty alone. Septoplasty + turbinoplasty resulted in a greater improvement in general health than septoplasty alone, despite the same improvement in nasal obstruction, indicating a beneficial effect of additional turbinoplasty in septoplasty.

摘要

背景

鼻中隔成形术和鼻甲成形术的患者报告结局研究大多涉及几位具有不同手术技能、技术和经验的外科医生。本研究旨在评估一位经验丰富的外科医生的手术效果。

方法

纳入 366 例因鼻塞就诊的连续患者。所有患者均在充血消退前后进行鼻内镜检查,填写鼻 VAS 并在术前及术后 3-6 个月评价总体一般健康状况。患者行鼻中隔成形术、鼻中隔成形术加鼻甲成形术或单纯鼻甲成形术。

结果

所有患者术前鼻塞的平均鼻 VAS(0-100)为 64.7。行鼻中隔成形术的患者(n=159)比行鼻中隔成形术+鼻甲成形术的患者(n=79)或单纯行鼻甲成形术的患者(n=128)年龄更小。所有三组患者的鼻塞 VAS 均显著改善,鼻中隔成形术和鼻中隔成形术+鼻甲成形术组中 25%的患者术后鼻塞 VAS 正常,而单纯鼻甲成形术组中仅有 8%的患者如此。鼻中隔成形术和鼻中隔成形术+鼻甲成形术在改善鼻塞方面无显著差异,但鼻中隔成形术+鼻甲成形术组在改善总体健康方面有显著更大的改善。

结论

在由一位经验丰富的外科医生治疗的 366 例患者中,鼻中隔成形术和鼻中隔成形术+鼻甲成形术在缓解鼻塞方面比单纯鼻甲成形术更有效。尽管鼻塞改善相同,但鼻中隔成形术+鼻甲成形术组的总体健康状况改善更大,表明鼻甲成形术对鼻中隔成形术有额外的益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b4c/8382632/def0c278236c/405_2021_6696_Fig1_HTML.jpg

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