Ichimura K, Nibu K, Shimazaki Y, Kase Y, Tanaka T, Ogawa K, Kitahara N, Horiuchi Y
Department of Otorhinolaryngology, Faculty of Medicine, University of Tokyo.
Nihon Jibiinkoka Gakkai Kaiho. 1993 Jul;96(7):1051-7. doi: 10.3950/jibiinkoka.96.1051.
Nasal valve, originally defined by Mink (1903), has changed its concept and is now regarded as slit-like opening between the caudal end of the upper lateral cartilage and the septum. Contrary to Caucasians whose smallest area of the nose lies at the nasal valve, the narrowest part of Japanese nose situates at the area between the anterior portion of the inferior turbinate and the septum. Thus, we have fewer chance to experience patients with stenotic nasal valve. Six patients complaining nasal obstruction resulted from nasal valve stenosis, mainly due to dislocated or collapsed upper lateral cartilage, underwent surgery during the last 2 years and a half. Cases of septal deformity, even it it produced valve stenosis, were excluded in this study. Surgical intervention was directed toward reconstruction of normal anatomic relationships, usually by widening the nasal valve angle and preventing collapsibility. Three underwent open rhinoplasty with gull-wing columellar skin incision, whereas 3 others were operated on via transnostril approach. History of midfacial trauma caused us to choose open rhinoplasty for restoring the function and structure. Immediate postoperative result was excellent in the aspect of appearance and subjective data regardless of surgical approach. Open rhinoplasty provided a splendid long-term result without remarkable complications. On the other hand, 2 cases operated via transnostril approach complained recurrence of stuffy nose.
鼻瓣膜最初由明克（1903年）定义，其概念已发生变化，现在被视为上外侧软骨尾端与鼻中隔之间的裂隙样开口。与白种人不同，白种人的鼻子最小面积位于鼻瓣膜处，而日本人鼻子最窄的部分位于下鼻甲前部与鼻中隔之间的区域。因此，我们遇到鼻瓣膜狭窄患者的机会较少。在过去两年半中，有6例因鼻瓣膜狭窄导致鼻塞的患者接受了手术，主要原因是上外侧软骨脱位或塌陷。本研究排除了鼻中隔畸形病例，即使其导致了瓣膜狭窄。手术干预旨在重建正常的解剖关系，通常通过扩大鼻瓣膜角度并防止塌陷。3例采用海鸥翼状鼻小柱皮肤切口行开放式鼻整形术，另外3例通过经鼻孔入路进行手术。面中部外伤史使我们选择开放式鼻整形术来恢复功能和结构。无论手术方式如何，术后即刻在外观和主观数据方面的结果都非常好。开放式鼻整形术提供了出色的长期效果，且无明显并发症。另一方面，2例经鼻孔入路手术的患者抱怨鼻塞复发。
