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机构地区:[1]上海交通大学医学院附属第九人民医院耳鼻咽喉科,上海200011 [2]上海交通大学医学院附属第九人民医院口腔颌面外科,上海200011
出 处:《中国耳鼻咽喉头颈外科》2014年第11期591-593,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery
摘 要:目的探讨对存在鼻腔阻塞、鼻中隔偏曲的牙颌面畸形患者行上颌骨Le Fort I型截骨上颌骨前移术的同期行鼻中隔矫正术对鼻腔通气功能的影响。方法对13例I I I类错颌畸形并伴有鼻中隔偏曲,鼻腔阻塞症状的患者进行前瞻性研究,年龄18~45岁,手术方案包括上颌骨Le For t I型截骨前移术及鼻中隔矫正术。术前、术后3个月及术后6个月对研究对象分别进行前鼻镜检查及鼻声反射检查。术前及术后6个月,完成鼻腔阻塞症状评估量表(nasal obstruction symptom evaluation scale,NOSE)的主观性评估。采用SPSS13.0对术前、术后的结果进行配对t检验。结果鼻声反射检测结果显示研究组的鼻腔阻力、鼻腔容积及鼻腔最小截面积术后3个月及6个月较术前有显著改善。NOSE量表的主观性评估结果显示,术后6个月时的评估分值较术前下降,前后差异有统计学意义。结论上颌骨Le Fort I型截骨上颌骨前移手术同期行鼻中隔矫正术可以明显增加患者的鼻腔容积,改善鼻腔通气。OBJECTIVE Our aim was to assess nasal airway changes after Le Fort Ⅰ-osteotomy combined with septoplasty in patients with maxillary dysplasia both objectively and subjectively. METHODS Thirteen patients with class Ⅲ malocclusion also had septum deviation and nasal obstruction with age ranged from 18 to 45 years, whose surgical treatment plan included Le Fort I-osteotomy and septoplasty, were included in this study. Preoperation, 3 and 6 months after operation, rhinological inspection and acoustic rhinometry (AR) were performed. The Nasal Obstruction Symptom Evaluation (NOSE) scale was also completed before and after operation. SPSS was used to analyze the data. RESULTS Acoustic rhinometry assessment showed improvements of NAR, NV and MCA in our study group at 3 and 6 months postoperatively. The improvements had statistical significance. Significant improvement in nasal breathing was also documented (by NOSE scores) at 6 months after surgery. CONCLUSION Le Fort Ⅰ-osteotomy combined with septoplasty were effective for improving nasal airway function in patients with maxillary dysplasia. The combination of objective (AR) and subjective (NOSE scale) assessment allowed better evaluation of the structure and function of the nose.
关 键 词:上颌骨 外科 口腔 鼻中隔 鼻测量 声学 生活质量 鼻塞 内窥镜检查
分 类 号:R765.9[医药卫生—耳鼻咽喉科] R782[医药卫生—临床医学]
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