Rettinger G, Engelbrecht-Schnür S
HNO-Klinik, Universität Erlangen.
Laryngorhinootologie. 1995 May;74(5):282-5. doi: 10.1055/s-2007-997740.
A certain percentage of patients complain of numbness or pain in the palatine mucosa, posterior to the incisors, following septal surgery. The symptoms arise from lesions of the nasopalatine nerve near the floor of the nose. In order to demonstrate the sequelae of these lesions, we performed a prospective study on 31 individuals undergoing septoplasty. A maxillary-premaxillary approach to the nasal floor was used on one side in a group of 13 patients and on both sides in a group of 18 patients according to the respective unilateral or bilateral septal pathology. Unilateral or bilateral division of the nasopalatine nerves was anticipated. The threshold of sensitivity to a direct current of up to 500 mA with pulses of 100 msec duration was determined preoperatively. The test was repeated 8 days postoperatively at 5 defined points of the palatine mucosa: posterior to both incisors and both canine teeth and at the incisive papilla. In addition, the patients were questioned about distinct palatine sensations 8 days and 3 to 5 months after septoplasty. Neither group showed any significant elevation of the threshold of sensitivity to a direct current 8 days postoperatively, regardless of whether unilateral or bilateral subperiostal tunnels of the nasal floor had been. However, thirteen patients (32%) described disturbances of sensitivity, most frequently numbness or soreness. The symptoms occurred in both groups with equal distribution. After an interval of 3 to 5 months postoperatively, 16% of all operated patients still had some kind of palatine discomfort.(ABSTRACT TRUNCATED AT 250 WORDS)
一定比例的患者在鼻中隔手术后抱怨切牙后方的腭黏膜出现麻木或疼痛。这些症状源于鼻底附近的鼻腭神经损伤。为了证明这些损伤的后遗症,我们对31例接受鼻中隔成形术的患者进行了一项前瞻性研究。根据各自的单侧或双侧鼻中隔病变情况,在一组13例患者中一侧采用上颌 - 前上颌入路至鼻底,在另一组18例患者中双侧采用该入路。预计会进行单侧或双侧鼻腭神经切断。术前测定对持续时间为100毫秒、高达500毫安直流电的敏感阈值。术后8天在腭黏膜的5个特定点重复该测试:双侧切牙后方、双侧尖牙后方以及切牙乳头处。此外,在鼻中隔成形术后8天以及3至5个月询问患者关于明显的腭部感觉。术后8天,无论是否进行了单侧或双侧鼻底骨膜下隧道操作,两组患者对直流电的敏感阈值均未出现任何显著升高。然而,13例患者(32%)描述了感觉障碍,最常见的是麻木或酸痛。两组症状出现的分布相同。术后3至5个月后,所有接受手术的患者中有16%仍有某种腭部不适。(摘要截短于250字)