Department of Otorhinolaryngology, Head & Neck Surgery, "Nuovo Santo Stefano" Civil Hospital, Via Suor Niccolina Infermiera, 20/22, Prato, PO 59100, Italy.
Department of Surgery and Biomedical Sciences, Section of Otorhinolaryngology, "Santa Maria della Misericordia" University Hospital, Sant'Andrea delle Fratte, Perugia, PG 06129, Italy.
Auris Nasus Larynx. 2021 Oct;48(5):914-921. doi: 10.1016/j.anl.2021.02.017. Epub 2021 Mar 6.
Many authors have investigated the most appropriate surgical approach to the deviated septum in childhood, considering the obligate mouth-breathing habit a possible cause of malocclusion and disharmonious development of the facial skeleton in growing kids. Nevertheless, controversies still remain about the long-term functional/esthetic results of such procedures, mainly due to the duration of the follow-up and possible confounding factors.
111 Caucasian children (age range: 6-13 years) were submitted to a personal "Quick" septoplasty surgical technique between 2005 and 2010. Preoperative otorhinolaryngological examination using flexible nasal endoscopy, anterior active rhinomanometry (AAR), Nasal Obstruction Septoplasty Effectiveness (NOSE) questionnaire, and dentofacial evaluation (including cephalometry) were performed. Postoperative AAR, NOSE questionnaire and cephalometric assessment were carried out in all patients at the age of 18 years. Informed consent was obtained from children's parents as appropriate.
No surgical complication was recorded. Among our patients, a significant (p <0.001) improvement of nasal breathing resistances at AAR and NOSE questionnaire scores was found after surgery. A significant improvement in cephalometric/dental parameters (gonial angle values, anterior facial height, prevalence of class I occlusion, maxillary intermolar width, and cross-bite frequency) was noticed after the follow-up with respect to preoperative conditions.
The "Quick" septoplasty technique described is a practical and conservative procedure with a low complication rate that offers long-term favourable results for the correction of nasal septum deviations in children. Nasal-breathing restoration may favor a physiological and harmonious development of craniofacial and dental structures in offspring.
许多作者研究了儿童鼻中隔偏曲最合适的手术方法,认为强制性口呼吸习惯可能是导致儿童错牙合畸形和面部骨骼发育不协调的原因。然而,由于随访时间和可能的混杂因素,这些手术的长期功能/美容效果仍存在争议。
2005 年至 2010 年间,111 名白种人儿童(年龄范围:6-13 岁)接受了个人“快速”鼻中隔成形术。术前使用鼻内窥镜、前鼻主动测压法(AAR)、鼻阻塞鼻中隔成形术效果(NOSE)问卷和牙颌面评估(包括头影测量)进行耳鼻喉科检查。所有患者在 18 岁时均行术后 AAR、NOSE 问卷和头影测量评估。根据情况获得了儿童家长的知情同意。
无手术并发症记录。在我们的患者中,AAR 和 NOSE 问卷评分的鼻腔呼吸阻力明显(p<0.001)改善。与术前情况相比,随访后发现头影测量/牙颌参数(下颌角值、前面部高度、I 类咬合患病率、上颌尖牙间宽度和交叉咬合频率)有显著改善。
描述的“快速”鼻中隔成形术是一种实用且保守的方法,并发症发生率低,可长期为儿童鼻中隔偏曲的矫正提供良好的效果。恢复鼻呼吸可能有利于颅面和牙齿结构的生理和协调发育。