Hosokawa Yu, Miyawaki Takeshi, Omura Kazuhiro, Akutsu Taisuke, Kimura Ryohei, Ikezono Tetsuo, Otori Nobuyoshi
Department of Otorhinolaryngology, Saitama Medical University, Saitama, Japan.
Department of Otorhinolaryngology, the Jikei University School of Medicine, Tokyo, Japan.
Ear Nose Throat J. 2025 Jul;104(7):NP408-NP415. doi: 10.1177/01455613221130885. Epub 2022 Sep 29.
Empty nose syndrome (ENS) is caused by nasal turbinate surgery. The standard treatment for ENS is an inferior meatus augmentation procedure (IMAP) in which autologous tissue such as auricular cartilage, rib cartilage, or artificial material is transplanted into the nasal cavity. However, some challenges like a very small auricular cartilage are associated with these autologous tissue types. Moreover, since using rib cartilage is a highly invasive technique, the scar on the chest from where the harvesting is done is easily visible, and the artificial material is susceptible to infection. We used autologous dermal fat (ADF) in IMAPs in our study for the following reasons: the quantity of ADF could be increased or reduced as needed, ADF is considered a safer option than rib cartilage because it is harvested from superficial tissue, it is superior in terms of cosmetic appearance to harvested rib cartilage, and it has a lower risk of infection than any artificial material. The purpose of our study was to investigate the efficacy and safety of IMAPs using ADF. We included nine patients with ENS who underwent an IMAP using ADF. The patients' backgrounds and responses to the Empty Nose Syndrome 6-Item Questionnaire (ENS6Q) were recorded. Changes in each item of the ENS6Q before and after surgery (up to 3 months) were analyzed. The postoperative ENS6Q total score and parameters were significantly better than their preoperative counterparts. Nasal dryness improved slightly less than other symptoms. There were no complications. The IMAP using ADF was effective in improving ENS symptoms; however, some physiological functions were difficult to improve, and dryness persisted. Autologous dermal fat is larger than auricular cartilage, less invasive than rib cartilage, and has a lower risk of infection than artificial material.
空鼻综合征(ENS)由鼻甲手术引起。ENS的标准治疗方法是下鼻道扩大术(IMAP),即将自体组织(如耳软骨、肋软骨)或人工材料移植到鼻腔。然而,这些自体组织类型存在一些问题,比如耳软骨非常小。此外,由于使用肋软骨是一种侵入性很强的技术,取材部位胸部的疤痕很容易看到,而且人工材料容易感染。在我们的研究中,我们在IMAP中使用自体真皮脂肪(ADF)有以下原因:ADF的量可根据需要增加或减少;ADF被认为比肋软骨更安全,因为它取自浅表组织;在外观方面,它比取材的肋软骨更优;而且它比任何人工材料的感染风险都低。我们研究的目的是调查使用ADF的IMAP的疗效和安全性。我们纳入了9例接受使用ADF的IMAP的ENS患者。记录了患者的背景情况以及他们对空鼻综合征6项问卷(ENS6Q)的回答。分析了手术前后(最长3个月)ENS6Q各项的变化。术后ENS6Q总分及各项参数均显著优于术前。鼻干症状的改善略低于其他症状。未出现并发症。使用ADF的IMAP对改善ENS症状有效;然而,一些生理功能难以改善,鼻干症状持续存在。自体真皮脂肪比耳软骨大,比肋软骨侵入性小,且比人工材料感染风险低。