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尾中隔偏曲矫正的比较研究

A Comparative Study of Correction of Caudal Septal Deviations.

作者信息

Ghosh Swapan Kr, Choudhary Ankit

机构信息

Burdwan Medical College and Hospital, Burdwan, West Bengal India.

IPGME&R, Kolkata, India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2024 Oct;76(5):3972-3977. doi: 10.1007/s12070-024-04757-x. Epub 2024 Jun 6.

Abstract

BACKGROUND

There are multiple surgical approaches for the correction of caudal septal deviation.

OBJECTIVES

To compare the surgical outcomes of the widely used techniques of correction of caudal septal deviation.

MATERIALS AND METHODS

In a prospective study done over a period of 3 years, 36 patients with caudal septal deviation were selected and randomly divided into 3 groups of 12 each who underwent surgery by the following techniques: Group A - Swinging Door technique. Group B- Tongue-in-groove technique. Group C- The cutting and suture technique with unilateral bony batten grafting. The preoperative and postoperative (at 6 months) NOSE score, anterior rhinoscopy and subjective assessment were used to measure surgical outcomes and the techniques were compared.

RESULTS

Out of the 36 patients, the mean NOSE score preoperatively and postoperatively were as follows. For Group A- 72.5 and 23.33. For Group B- 73.75 and 19.17. For Group C- 72 and 22. A significant improvement of mean 49.17, 54.58 and 50.00 with -value of < 0.05 respectively. Anterior rhinoscopy done at 6 months postoperatively showed that 30 patients (83%) had a straight septum while 6 patients (17%) had some residual deviation. Subjective patient satisfaction was "much improved" in 17 (47.2%) patients, and "improved" in 19 (52.8%) patients. Four patients had postoperative synechia which were managed conservatively.

CONCLUSION

Surgical correction of caudal septal deviation resulted in significant improvements in nasal airway. The tongue-in -groove technique was found to be the most effective among the three.

摘要

背景

对于尾中隔偏曲的矫正存在多种手术方法。

目的

比较广泛应用的尾中隔偏曲矫正技术的手术效果。

材料与方法

在一项为期3年的前瞻性研究中,选取36例尾中隔偏曲患者,随机分为3组,每组12例,分别采用以下技术进行手术:A组——摆动门技术;B组——榫槽技术;C组——单侧骨条移植切割缝合技术。采用术前及术后(6个月时)的鼻症状评估(NOSE)评分、前鼻镜检查和主观评估来衡量手术效果,并对这些技术进行比较。

结果

36例患者中,术前和术后的平均NOSE评分如下。A组:术前72.5,术后23.33;B组:术前73.75,术后19.17;C组:术前72,术后22。平均改善显著,分别为49.17、54.58和50.00,P值均<0.05。术后6个月的前鼻镜检查显示,30例患者(83%)鼻中隔变直,6例患者(17%)有一些残余偏曲。患者主观满意度方面,17例(47.2%)患者“改善明显”,19例(52.8%)患者“有所改善”。4例患者术后出现粘连,经保守治疗。

结论

尾中隔偏曲的手术矫正显著改善了鼻气道。榫槽技术在这三种技术中被发现是最有效的。

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本文引用的文献

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Caudal Septal Deviation: New Classification and Management Strategy.尾侧鼻中隔偏曲:新的分类与治疗策略
Indian J Otolaryngol Head Neck Surg. 2021 Dec;73(4):424-430. doi: 10.1007/s12070-020-01909-7. Epub 2020 Jun 19.
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Nasal valve: anatomy and physiology.鼻阀:解剖学与生理学。
Braz J Otorhinolaryngol. 2009 Mar-Apr;75(2):305-10. doi: 10.1016/s1808-8694(15)30795-3.
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Caudal septal deviation.鼻中隔尾端偏曲
Otolaryngol Clin North Am. 2009 Jun;42(3):427-36. doi: 10.1016/j.otc.2009.03.005.

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