Abo El Naga Heba A, Hamdan Ahmad M
Otolaryngology Department, 68872Faculty of Medicine, Menoufia University, Shebin Elkom, Menoufia, Egypt.
Am J Rhinol Allergy. 2023 Jan;37(1):89-94. doi: 10.1177/19458924221135709. Epub 2022 Oct 27.
A nasal septal dislocation is a common form of septal deviation with many challenges and different surgical techniques for correction.
To assess the efficacy of fashioned mucoperichondrial flap technique versus fishing line technique in the repair of septal dislocation.
The study was a prospective comparative cohort study conducted on 88 patients aged above 18 years who have symptomatic mild to moderate caudal septal dislocation spanning the period from June 2021 to June 2022. Preoperatively, all patients were evaluated by the Nasal Obstruction and Septoplasty Effectiveness (NOSE) scale to assess the degree of nasal obstruction. Anterior rhinoscopy and endoscopic examination of the nose were done for every patient to assess the degree of obstruction, whether mild, moderate, or severe. Outcomes included an assessment of both techniques' efficacy in managing nasal obstruction as expressed by the NOSE scale and comparing both techniques regarding the operative and postoperative details.
The current study showed a highly significant improvement in the NOSE scale postoperatively in both groups ( < .00001 for both groups). The mean operative duration for group I was significantly less than that for group II ( < .00001). There was a nonsignificant difference between both groups regarding the postoperative NOSE scale, and postoperative degree of obstruction ( = .066 and .56, respectively) Regarding postoperative complications, there was a nonsignificant difference between both groups except for patient discomfort as assessed 1 week postoperatively. Group II showed significantly more patient discomfort ( = .02), which improved 4 weeks postoperatively.
Both techniques presented in this study effectively corrected mild and moderate caudal septal dislocation with significant improvement of nasal obstruction postoperatively. Both techniques produced good esthetic outcomes and were associated with few comparable complications in both groups.
鼻中隔脱位是鼻中隔偏曲的一种常见形式，矫正时面临诸多挑战且有不同的手术技术。
评估改良黏膜软骨膜瓣技术与丝线技术修复鼻中隔脱位的疗效。
本研究为前瞻性比较队列研究，对2021年6月至2022年6月期间88例年龄在18岁以上、有症状的轻度至中度鼻中隔尾端脱位患者进行研究。术前，所有患者均通过鼻阻塞和鼻中隔成形术有效性（NOSE）量表评估鼻阻塞程度。对每位患者进行前鼻镜检查和鼻内镜检查，以评估阻塞程度，无论是轻度、中度还是重度。结果包括通过NOSE量表评估两种技术在处理鼻阻塞方面的疗效，以及比较两种技术在手术和术后细节方面的情况。
本研究显示两组术后NOSE量表均有极显著改善（两组均P<0.00001）。第一组的平均手术时间显著短于第二组（P<0.00001）。两组术后NOSE量表及术后阻塞程度之间无显著差异（分别为P=0.066和P=0.56）。关于术后并发症，除术后1周评估的患者不适外，两组之间无显著差异。第二组患者不适明显更多（P=0.02），术后4周有所改善。
本研究中的两种技术均有效矫正了轻度和中度鼻中隔尾端脱位，术后鼻阻塞有显著改善。两种技术均产生了良好的美学效果，且两组的并发症较少且相当。
