de Monredon O, Dumon T h, Stoll D
C.H.U. Pellegrin, Clinique Universitaire O.R.L., Bordeaux, France.
Rev Laryngol Otol Rhinol (Bord). 1998;119(1):29-34.
A retrospective study of the records of 392 consecutive patients prospectively operated for non-vasomotor nasal obstruction, has allowed us to identify a syndrome that we would call morphological syndrome. This is caused by anatomical deformities of the nasal septum, inferior turbinate hypertrophy frequently found being the most often only a compensation for the septal deviation. This endonasal abnormality, which can be congenital or post-traumatic, is most frequently of developmental origin and therefore most often found in Caucasian men, whose facial and septal growth is considerable. This morphological syndrome comprises unilateral or bilateral nasal obstruction, noisy nocturnal breathing (20% of patients), a posterior nasal drip (38% of patients), frontal headaches (49% of patients) and recurrent viral or bacterial rhinosinusitis (36% of patients). Other associated symptoms include epistaxis, olfactory dysfunction (hyposmia) and the manifestations of eustachian tube dysfunction. That this syndrome exists is confirmed by the effectiveness of septoplastic operation, performed in our hospital according to the method of Cottle, but without any surgical associated intervention on the inferior turbinates. This operation is an effective treatment both in a global fashion (95% of good results) and in relation to each of the symptoms (except postnasal drip) and is stable in the longterm and well tolerated (minor associated morbidity). This study allow us to re-establish the almost exclusive role of the nasal septum in the genesis of morphological nasal obstruction.
对392例因非血管运动性鼻阻塞而接受前瞻性手术的连续患者的记录进行回顾性研究，使我们得以识别出一种我们称之为形态学综合征的病症。它由鼻中隔的解剖畸形引起，经常发现的下鼻甲肥大往往只是鼻中隔偏曲的一种代偿。这种鼻内异常情况可能是先天性的，也可能是创伤后形成的，最常见的是发育性起源，因此在白种男性中最为常见，他们的面部和鼻中隔生长较为显著。这种形态学综合征包括单侧或双侧鼻阻塞、夜间呼吸有声（20%的患者）、鼻后滴漏（38%的患者）、额部头痛（49%的患者）以及复发性病毒性或细菌性鼻-鼻窦炎（36%的患者）。其他相关症状包括鼻出血、嗅觉功能障碍（嗅觉减退）以及咽鼓管功能障碍的表现。我们医院按照科特尔方法进行的鼻中隔成形术的有效性证实了这种综合征的存在，且该手术未对下鼻甲进行任何相关手术干预。这种手术无论是整体效果（95%的良好效果）还是针对每种症状（鼻后滴漏除外）都是一种有效的治疗方法，并且长期效果稳定，耐受性良好（相关并发症轻微）。这项研究使我们能够重新确立鼻中隔在形态学鼻阻塞发生过程中几乎独一无二的作用。
