Zijlker T D, Quaedvlieg P C
Department of Otorhinolaryngology/Head and Neck Surgery, De Wever Hospital, Heerlen, The Netherlands.
Rhinology. 1994 Mar;32(1):34-41.
Nasal valve insufficiency (NVI) is a troublesome clinical entity for both the patient and the otorhinolaryngologist. Aetiological factors include congenital and iatrogenic causes, trauma, aging. Pathology is frequently located in the middle third of the nose: the upper lateral cartilages (ULC) and the cartilaginous septum (CS). The nasal valve (NV) is the plane through the caudal edges of the ULC and the CS, and is part of a larger three-dimensional area called the nasal valve area (NVA). The NVA is considered to have the narrowest cross-sectional area of the entire airway. Between 1989-1992, 32 patients with nasal obstruction due to an incompetent nasal valve were surgically treated by lateral augmentation with autologous cartilage "spreader" grafts, placed between the CS and the ULC to widen the apex of the NVA. In all cases the open approach for rhinoplasty (OSR) was used. After a mean follow-up of 18 months, 27 patients were evaluated by a self-administered questionnaire, head-and-neck examination, nasal endoscopy, photography and video-documentation of the NVA. The patient's subjective opinion was used in the assessment of the surgical success. In 48% of the patients there was complete resolution of complaints. An overall improvement of nasal patency was seen in 81% of the cases. No major complications occurred. The indications, technique and results are presented.
鼻瓣功能不全（NVI）对于患者和耳鼻喉科医生来说都是一个棘手的临床问题。病因包括先天性和医源性因素、创伤、衰老。病变常位于鼻腔的中三分之一：上外侧软骨（ULC）和鼻中隔软骨（CS）。鼻瓣（NV）是通过ULC和CS尾缘的平面，是一个更大的三维区域即鼻瓣区（NVA）的一部分。NVA被认为是整个气道中横截面积最窄的部位。1989年至1992年间，32例因鼻瓣功能不全导致鼻塞的患者接受了手术治疗，通过在CS和ULC之间植入自体软骨“撑开器”移植物进行外侧增强，以扩大NVA的顶点。所有病例均采用开放式鼻整形术（OSR）。平均随访18个月后，通过自我管理问卷、头颈检查、鼻内镜检查、摄影及NVA的视频记录对27例患者进行了评估。手术成功的评估采用患者的主观意见。48%的患者症状完全缓解。81%的病例鼻通畅情况总体改善。未发生重大并发症。本文介绍了手术适应证、技术及结果。
