鼻内入路鼻内镜辅助下鼻-鼻中隔整形术的疗效观察  

Evaluating the efficiency of endoscope-assisted septo-rhinoplasty via intranasal approach

作　　者：黄冠 亚森江·阿布都热依木 关亚峰 马玲 周萍 丁印 Huang Guan;Abdurehim Yasin;Guan Yafeng;Ma Ling;Zhou Ping;Ding Yin(Department of Otorhinolaryngology Head and Neck Surgery,the University of Hong Kong-Shenzhen Hospital,Shenzhen 518053,China)

机构地区：[1]香港大学深圳医院耳鼻咽喉头颈外科,深圳518053

出　　处：《中华耳鼻咽喉头颈外科杂志》2023年第12期1232-1237,共6页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

摘　　要：目的观察鼻内入路鼻内镜辅助下鼻-鼻中隔整形术的临床疗效。方法收集2021年6月至2022年6月就诊于香港大学深圳医院耳鼻咽喉头颈外科的12例鼻中隔偏曲合并外鼻形态异常患者的临床资料,其中男性8例,女性4例,年龄28~58岁。所有患者均于全身麻醉下进行手术,采取鼻内半贯通切口矫正鼻中隔偏曲,同时依据病情需要联合软骨间切口、下鼻甲前缘切口等,行截骨、驼峰矫正、鞍鼻矫正等手术操作。分别采用鼻阻塞症状评估量表(Nasal Obstruction Symptom Evaluation,NOSE)、鼻整形结果评估量表(Rhinoplasty Outcome Evaluation,ROE)、视觉模拟量表(VAS)评估患者对术后鼻塞及鼻外形改善的满意程度。采用SPSS 25.0软件进行统计学分析。结果全部12例患者术后鼻中隔偏曲矫正满意,鼻塞程度显著减轻。鼻通气NOSE评分及VAS评分均降低[(21.67±10.30)分比(70.83±14.12)分,(1.83±1.03)分比(8.33±0.89)分,t值分别为9.49、16.30,P值均<0.05]。10例合并歪鼻畸形的患者鼻外形明显改善,鼻外形ROE评分及VAS评分均提高[(21.30±2.31)分比(8.10±3.31)分,(8.90±0.99)分比(3.80±1.62)分,t值分别为-11.85、-9.33,P值均<0.05]。2例合并鼻前庭形态异常的患者鼻前庭形态改善。随访12~24个月,均未出现鼻中隔穿孔、鼻腔粘连、鼻背塌陷等并发症。结论通过鼻内入路鼻内镜辅助下鼻-鼻中隔整形术,可同期改善患者的鼻腔通气功能及鼻形态,在减少手术创伤的同时让患者受益。Objective To observe the functional and esthetic results of endoscope-assisted septo-rhinoplasty via intranasal approach.Methods The clinical data of 12 patients with septal deviation and nasal deformity in the University of Hong Kong-Shenzhen Hospital from June 2021 to June 2022 were analyzed,including 8 males and 4 females,aging 28 to 58 years.All patients were operated under general anesthesia.The septal deviation was corrected by hemitransfixion incision,combined with intercartilaginous incision and other intranasal or extranasal incisions to perform osteotomy,hump resection and saddle nose correction.Patient satisfaction with postoperative functional and aesthetic improvements was assessed through Nasal Obstruction Symptom Evaluation(NOSE),Rhinoplasty Outcome Evaluation(ROE),and Visual Analogue Scale(VAS).SPSS 25 software was used for statistical analysis.Results The correction of nasal septum deviation was satisfactory in all 12 patients.Nasal obstruction was relieved,with NOSE score and VAS score of nasal ventilation decreased[(21.67±10.30)vs(70.83±14.12),(1.83±1.03)vs(8.33±0.89),t value was 9.49 and 16.30,respectively,both P<0.05].The nasal appearance of 10 patients with crooked nose deformity was improved,with ROE score and VAS score of nasal appearance increased[(21.30±2.31)vs(8.10±3.31),(8.90±0.99)vs(3.80±1.62),t value was-11.85 and-9.33,respectively,both P<0.05];The nasal vestibule morphology of 2 patients with abnormal nasal vestibule was improved.During the follow-up of 12 to 24 months,no postoperative complication such as nasal septum perforation,nasal cavity adhesion or nasal dorsal collapse occurred in all patients.Conclusion Endoscope-assisted septo-rhinoplasty via intranasal approach can resolve both functional and esthetic problems at the same time,improving outcomes while reducing surgical trauma.

关 键 词：鼻内入路 内镜 鼻中隔偏曲 歪鼻畸形 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]