Martins de Sousa Mafalda, Rebelo João, Martins Sónia, Silveira Helena, Órfão Tiago, Pinto Moura Carla
Otorhinolaryngology, Centro Hospitalar Universitário São João, Porto, PRT.
Radiology, Centro Hospitalar Universitário São João, Porto, PRT.
Cureus. 2023 May 4;15(5):e38558. doi: 10.7759/cureus.38558. eCollection 2023 May.
Septoplasty is one of the most common surgeries performed by otorhinolaryngologists. The gold standard for the evaluation of septal deviation is anterior rhinoscopy and nasal endoscopy. Frequently, computed tomography (CT) is also performed, although the correlation between septal deviation on CT and physical examination is unclear.
To study the relationship between symptoms and physical and radiological evaluation in patients who underwent septoplasty.
A prospective study of patients with nasal obstruction and septal deviation who underwent septoplasty. Anterior rhinoscopy and nasal endoscopy were performed by the surgeon, and the CT was evaluated by a radiologist. The degree of obstruction was evaluated in three distinct septal locations. The Nasal Obstruction Symptom Evaluation (NOSE) score was used before the surgery and two months after the surgery.
The study included 43 patients, of whom 60.5% were male, with an average age of 37.09 years (±12.56). The degree of septal deviation in the physical examination was significantly different from that observed in CT (p˂0.05). Cartilaginous or maxillary crest septal deviations >75% were more commonly recognized by physical examination, while osseous septum deviations of 25%-50% were more easily detected by CT. There was no difference between the degree of septal deviation and the preoperative NOSE. The median preoperative NOSE was 60, and the postoperative was 5, with significant improvement (p<0.05).
CT doesn't appear to be useful in the evaluation of septal deviation since it is different from the findings of a physical examination and isn't associated with the NOSE score. Clinical decisions should be based on a physical examination and patient complaints.
鼻中隔成形术是耳鼻喉科医生最常进行的手术之一。鼻中隔偏曲评估的金标准是前鼻镜检查和鼻内镜检查。虽然CT与体格检查中鼻中隔偏曲之间的相关性尚不清楚，但CT检查也经常进行。
研究接受鼻中隔成形术患者的症状与体格检查及影像学评估之间的关系。
对因鼻塞和鼻中隔偏曲而接受鼻中隔成形术的患者进行前瞻性研究。由外科医生进行前鼻镜检查和鼻内镜检查，由放射科医生评估CT检查结果。在鼻中隔的三个不同部位评估阻塞程度。术前及术后两个月使用鼻阻塞症状评估（NOSE）评分。
该研究纳入43例患者，其中60.5%为男性，平均年龄37.09岁（±12.56）。体格检查中鼻中隔偏曲程度与CT检查结果有显著差异（p<0.05）。体格检查更常发现软骨或上颌嵴鼻中隔偏曲>75%，而CT更容易检测到骨鼻中隔偏曲25%-50%。鼻中隔偏曲程度与术前NOSE评分之间无差异。术前NOSE评分中位数为60，术后为5，有显著改善（p<0.05）。
由于CT检查结果与体格检查结果不同且与NOSE评分无关，因此CT在评估鼻中隔偏曲方面似乎并无用处。临床决策应基于体格检查和患者主诉。
