鼻内镜下鼻内切口、鼻骨截骨术在歪鼻-鼻中隔偏曲整形术中的应用  

The application of endoscopic nasal incision and nasal bone osteotomy in the rhinoplasty of the nasal deviation and nasal septum deviation

作　　者：高娴[1] 孙铭宏 郭朝斌[1] 李永团 GAO Xian;SUN Minghong;GUO Chaobin;LI Yongtuan(Department of Otolaryngology-Head and Neck Surgery,Qingdao Municipal Hospital,the Third Affiliated Hospital of Qingdao University,266071,Qingdao,China)

机构地区：[1]青岛大学附属青岛市市立医院东院耳鼻咽喉头颈外科,266071

出　　处：《中国中西医结合耳鼻咽喉科杂志》2018年第5期346-349,共4页Chinese Journal of Otorhinolaryngology in Integrative Medicine

基　　金：山东省医药卫生科技发展计划项目(2017WS629)

摘　　要：目的探讨行鼻内镜下鼻内切口、联合截骨术行鼻中隔矫正和鼻畸形整复术的治疗效果。方法选择鼻中隔偏曲合并歪鼻的患者共28例,抽签法随机分为实验组及对照组,实验组行鼻内切口,在内镜辅助下,同期进行鼻中隔偏曲矫正术以及鼻骨截骨术;对照组患者行常规鼻中隔切口及三线减张法鼻中隔偏曲矫正术。入组病例均在术前及术后3个月后进行鼻腔通气功能检查(视觉评分量表VAS)、鼻内镜检查以及鼻外形的视觉评分量表(VAS),以评估手术效果。结果 28例患者术后鼻腔通气功能均得到了明显改善,两组患者的鼻通气VAS平均分为9.16±0.99分及9.04±0.61分。远期无鼻中隔穿孔及嗅觉下降。其VAS评分与术前比较具有显著性差异(P<0.0001)。对于鼻外形的满意程度,视觉评分量表提示平均评分为8.72±0.18分及6.37±0.92分,与术前相比均具有显著性差异;其中满意为10例(71.4%),基本满意为4例(28.6%)。而实验组与对照组相比,患者术后的鼻外形满意度具有显著性差异。结论鼻内切口联合鼻骨截骨术可以明显改善患者的鼻腔通气及鼻外形;与常规鼻中隔矫正术相比较,鼻内切口联合鼻骨截骨术可以显著改善患者鼻外形满意度。采用鼻内切口在鼻内镜下进行截骨手术操作,在可视的情况下,可以更加精准的对鼻骨进行分离及截取。Objective To explore the feasibility of endoscopic nasal incision and nasal bone osteotomy in combination plastic operation on the nasal deviation and nasal septum deviation. Methods 28 patients, diagnosed as nasal deviation and nasal septum deviation, were operated with the endoscopic nasal incision and nasal bone osteotomy in treatment group and usual nasal septum correction in control group. 3 months postoperatively, operation effect was evaluated by the nasal airway function （visual rating scale VAS） and the nasal endoscopy, in addition, nasal shape was judged by the visual rating scale （VAS） at the same time. Results After at least 3 months following up, 10 cases（71.43%） were satisfied and 4 cases（28.57%） were satisfied basally. Conclusions Compared with the control group, the nose shape satisfaction of the experimental group was significantly different. The combined plasty of the nasal deviation and the nasal septum deviation could solve simultaneously the cosmetic problem of nasal deviation and the nasal dysfunction caused by nasal septum deviation.

关 键 词：鼻内切口 鼻骨截骨术 歪鼻畸形 鼻中隔偏曲 鼻中隔成形术 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]