伴慢性鼻及鼻窦炎的外伤性歪鼻畸形一期鼻功能性整复  

Stage-I functional reconstruction of traumatic deviated nose deformity with chronic rhino-sinusitis

作　　者：王成元[1] 宋剑武 杨大章[1] 

机构地区：[1]卫生部中日友好医院耳鼻咽喉头颈外科,北京100029 [2]秦皇岛市港口医院耳鼻咽喉科,河北秦皇岛066000

出　　处：《中国耳鼻咽喉头颈外科》2009年第5期263-266,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨伴慢性鼻及鼻窦炎的外伤性歪鼻畸形一期鼻功能性整复的可能性、手术方法、术后疗效及手术并发症。方法选择37例伴慢性鼻及鼻窦炎的外伤性歪鼻畸形患者,一期行鼻中隔矫正、功能性鼻内镜手术、鼻甲手术、歪鼻矫正等。术后1个月随访观察外鼻形状,并测量术后偏离值。术后3个月对慢性鼻及鼻窦炎症状行主观评分和内镜下评分,评分结果行统计学处理。结果37例歪鼻患者,术前偏离值为(6.64±2.21)mm,术后偏离值为(2.04±0.97)mm,手术前、后偏离值差别有显著性意义(t=6.374,P<0.001),其中歪鼻治愈率83.8%(31/37)、有效率16.2%(6/37)。慢性鼻及鼻窦炎治愈率为95.4%,手术前、后急性鼻窦炎复发、嗅觉、鼻腔通气、鼻腔分泌物、头痛、总体症状改善6项评分经t检验,差异均有统计学意义。结论伴慢性鼻及鼻窦炎的外伤性歪鼻畸形一期鼻功能性整复,一次手术同时完成鼻功能重建及外形矫正,符合现代鼻外科学发展要求,具有推广价值。OBJECTIVE To explore the feasibility, surgical method, surgical effect and postoperative complications of stage-Ⅰ functional reconstruction of traumatic deviated nose deformity accompanied with chronic rhino-sinusitis. METHODS 37 patients with traumatic deviated nose deformity accompanied with chronic rhino-sinusitis were selected in this study. Methods of stage-Ⅰ reconstruction included endoscopic nasal septoplasty, functional endoscopic sinsus surgery （FESS） , turbinectomy, rhinoplasty and so on. The patients were followed up for one month after operation. The shape of the nose was observed and the nasal bias was measured also. At 3 months after operation, the therapeutic effect about the chronic nasosinusitis was estimated by endoscopic check and patients＇ subjective symptom, The data obtained preoperatively and postoperatively were treated with statistical methods. RESULTS 37 patients with traumatic deviated nose deformity were selected in this study. The postoperative bias was 2.04 ±0.97 mm and preoperative bias was （6.64±2.21） mm. A t-test revealed the significant difference between pre- and postoperative bias （t=6.374, P〈0.001） . The cure rate and effective rate of deviated nose deformity were 83.8% （31/37） and 16.2% （6/37） respectively; the cure rate of chronic rhino-sinusitis was 95.4%, there were significance between pre- and postoperative scores （recurrence of infection, sense of smell, nasal congestion, nasal discharge, headache, overall improvement） confirmed by t-test. No postoperative complication was observed in this study. CONCLUSION Concurrent surgery of rhinoplasty and FESS can simultaneously reconstruct both nasal contour and its function, which satisfactorily meets the requirement of modern rhinology and has great value to be recommended.

关 键 词：鼻窦炎 鼻畸形 获得性 鼻成形术 

分 类 号：R765[医药卫生—耳鼻咽喉科]