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小儿鼻中隔成形术:益处、挑战及临床建议——对年轻ESPO的全面综述

Pediatric Septoplasty: Benefits, Challenges, and Clinical Recommendations-Comprehensive Review of Young ESPO.

作者信息

Zieliński Jakub, Costa Sara, Cherkes Maryana, Glibbery Natalia, Kovács Petra, Mitrea-Sirețeanu Luiza, Ciller Marek, Yılmaz Topçuoğlu Miray-Su

机构信息

Department of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University, 50-367 Wroclaw, Poland.

Department of Otolaryngology-Head and Neck Surgery, Unidade Local de Saúde de Santo António, 4050-342 Porto, Portugal.

出版信息

J Clin Med. 2025 Aug 6;14(15):5537. doi: 10.3390/jcm14155537.

Abstract

This comprehensive review examines the role of septoplasty in the pediatric population, emphasizing its therapeutic significance in relieving nasal obstruction and facilitating normal craniofacial growth. Despite the evident advantages of septoplasty, its application in young patients remains a subject of ongoing debate. This issue is primarily characterized by concerns regarding the still-developing immaturity of nasal cartilage, potential intraoperative and postoperative risks, and the current absence of robust data on long-term outcomes following septoplasty. Common complications such as bleeding, septal perforation, saddle nose deformity, and persistent nasal obstruction are reported in the literature; however, many studies lack long-term follow-up data on the incidence of these adverse events and revision rates, which may be higher compared to adult populations, often leading to the need for secondary surgical interventions. Strict inclusion criteria and comprehensive patient selection are paramount to maximize therapeutic success while minimizing complications. Current evidence suggests that appropriately indicated septoplasty can improve airway patency, support optimal facial development, and reduce the risk of secondary sinonasal pathology. There is a significant necessity for additional prospective, large-scale studies to establish standardized therapeutic guidelines and management strategies for this specific population, thereby ensuring effective and evidence-based pediatric otolaryngologic care.

摘要

这篇综述探讨了鼻中隔成形术在儿科患者中的作用,强调其在缓解鼻阻塞和促进正常颅面生长方面的治疗意义。尽管鼻中隔成形术有明显优势,但其在年轻患者中的应用仍是一个持续争论的话题。这个问题主要体现在对鼻软骨仍在发育的不成熟性、潜在的术中及术后风险,以及目前缺乏鼻中隔成形术后长期结果的有力数据的担忧上。文献报道了诸如出血、鼻中隔穿孔、鞍鼻畸形和持续性鼻阻塞等常见并发症;然而,许多研究缺乏关于这些不良事件发生率和翻修率的长期随访数据,与成人相比,这些发生率可能更高,常常导致需要二次手术干预。严格的纳入标准和全面的患者选择对于在最大限度提高治疗成功率的同时最小化并发症至关重要。目前的证据表明,适当实施的鼻中隔成形术可以改善气道通畅性,支持最佳面部发育,并降低鼻窦继发病变的风险。非常有必要进行更多前瞻性、大规模研究,为这一特定人群制定标准化治疗指南和管理策略,从而确保有效的、基于证据的儿科耳鼻喉科护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8abb/12347891/c852b9befc53/jcm-14-05537-g001.jpg

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