Wang L, Han Y E, Yu X M, Li L, Li X, Yuan Y
Department of Otorhinolaryngology Head and Neck Surgery, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao 266035, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2023 Mar 30;58:333-338. doi: 10.3760/cma.j.cn115330-20220831-00531.
To analyse the clinical effect of endoscopy-assisted functional rhinoplasty. Twenty-one patients with congenital or traumatic deviated nose with nasal obstruction admitted to Qilu Hospital (Qingdao) from January 2018 to December 2021, including 8 males and 13 females, aged 22 to 46 years, were retrospectively analysed. Endoscopy-assisted functional rhinoplasty was performed in all patients. Deviated nasal septum was corrected, nasal septum cartilage graft was prepared through open approach assisted by endoscopy, the nasal frame structure was adjusted with the endoscopy-assisted rhinoplasty combined with middle and inferior turbinoplasty, and the patient's nasal ventilation function and external nose cosmetology were restored. Visual Analogue Scale (VAS), Nasal Obstruction Symptom Evaluation (NOSE), nasal acoustic reflex and nasal resistance were examined preoperatively and 6 months postoperatively. The minimum cross-sectional area of the first two nasal cavities (MCA) MCA1 and MCA2 and their distance between nostrils to the minimum cross-sectional area (MD) MD1 and MD2 were recorded, and the ratio of both sides (expressed in a/b) was calculated. The nasal volume of 5 cm depth from nostril (NV5) and nasal resistance total (RT) were recorded to evaluate the nasal ventilation function to analyse the clinical effect of functional rhinoplasty assisted by nasal endoscope. SPSS 25.0 software was used for statistical analysis. At 6 months after the operation, for nasal ventilation evaluation, the VAS and NOSE scores of nasal obstruction decreased significantly than those before the operation ((1.81±0.81) points (6.71±1.38) points, (4.19±2.06) points (12.05±2.67) points, all <0.05). In the objective indexes, MCA1, MCA2 and NV5 were significantly increased whereas RT, MCA1a/MCA1b, MCA2a/MCA2b, MD1a/MD1b and MD2a/MD2b were significantly decreased compared with those before the operation (all <0.05). The MD1 and MD2 levels before and after operation had no significant differences (all >0.05). In the evaluation of external nose morphology, postoperative ROE was significantly increased, and the deviation value of nasal appearance was significantly decreased ((16.19±2.56) points (10.24±3.24) points, (1.55±1.16) mm (5.63±2.41) mm, all <0.05). In terms of postoperative patient satisfaction, 19 cases (90.5%) were very satisfied with nasal ventilation function, 2 cases (9.5%) were satisfied with nasal ventilation function; 15 cases (71.4%) were very satisfied with nasal appearance, and 6 cases (28.6%) were satisfied with nasal appearance. Nasal endoscopy-assisted functional rhinoplasty can improve the nasal ventilation function and external nasal morphology at the same time, with good clinical effect and high patient satisfaction.
分析鼻内镜辅助功能性鼻整形术的临床效果。回顾性分析2018年1月至2021年12月在齐鲁医院（青岛）收治的21例先天性或外伤性鼻中隔偏曲伴鼻塞患者，其中男性8例，女性13例，年龄22至46岁。所有患者均行鼻内镜辅助功能性鼻整形术。矫正鼻中隔偏曲，在内镜辅助下经开放式入路制备鼻中隔软骨移植物，采用鼻内镜辅助鼻整形术联合中、下鼻甲成形术调整鼻支架结构，恢复患者鼻通气功能及鼻外形。术前及术后6个月检查视觉模拟评分（VAS）、鼻阻塞症状评估（NOSE）、鼻声反射及鼻阻力。记录双侧鼻腔前两个最小横截面积（MCA）MCA1和MCA2及其鼻孔至最小横截面积的距离（MD）MD1和MD2，并计算两侧比值（以a/b表示）。记录距鼻孔5 cm深度的鼻腔容积（NV5）和总鼻阻力（RT），以评估鼻通气功能，分析鼻内镜辅助功能性鼻整形术的临床效果。采用SPSS 25.0软件进行统计分析。术后6个月，在鼻通气评估方面，鼻塞的VAS和NOSE评分较术前显著降低（（1.81±0.81）分对（6.71±1.38）分，（4.19±2.06）分对（12.05±2.67）分，均<0.05）。在客观指标方面，与术前相比，MCA1、MCA2和NV5显著增加，而RT、MCA1a/MCA1b、MCA2a/MCA2b、MD1a/MD1b和MD2a/MD2b显著降低（均<0.05）。手术前后MD1和MD2水平无显著差异（均>0.05）。在鼻外形评估方面，术后ROE显著增加，鼻外观偏差值显著降低（（16.19±2.56）分对（10.24±3.24）分，（1.55±1.16）mm对（5.63±2.41）mm，均<0.05）。在术后患者满意度方面，19例（90.5%）对鼻通气功能非常满意，2例（9.5%）对鼻通气功能满意；15例（71.4%）对鼻外观非常满意，6例（28.6%）对鼻外观满意。鼻内镜辅助功能性鼻整形术可同时改善鼻通气功能和鼻外形，临床效果良好，患者满意度高。
