内镜下鼻中隔修正手术

Nasal endoscopic revisional operation of nasal septum

目的探讨鼻中隔矫正术失败而行内镜下鼻中隔修正手术的技术方法。方法对1997年4月～2006年4月鼻中隔矫正术失败的39例患者进行鼻内镜检查,根据患者鼻中隔偏曲的部位、程度,原有软骨及骨质的残留状况,在内镜下采用2种不同的手术切口(径路)进行手术:对10例鼻中隔前下端偏曲,1例低位偏曲和14例高位偏曲的患者采用鼻中隔前端"C"形切口;对12例鼻中隔后端偏曲和2例高位偏曲患者,在偏曲部位的前方作小弧形切口;必要时辅助电钻或骨锉进行手术。结果39例患者均获满意矫正,鼻中隔偏曲引起的临床症状消失或明显改善。随访6～24个月,无1例出现鼻中隔穿孔、鞍鼻、鼻腔粘连等并发症。结论内镜下鼻中隔修正手术针对不同的临床特点选择正确的手术方法,可获满意效果,是一种鼻中隔偏曲矫正术失败进行补救行之有效的方法。

[ Objective] To investigate the techniques and methods of nasal endoscopic revisional operation for the failures of nasal septal constructions. [Methods] 39 patients with failures of nasal septal constructions from April 1997 to April 2006 accepted nasal endoscopic examinations. According to the location, extent, residue of cartilage and sclerotin, two different surgical incisions were performed with nasal endoscope： 10 cases with anterior and inferior terminal deflection of nasal septum, 1 case with low set deflection and 14 cases with high set deflection undertook ＂C＂ incision; 12 cases with posterior terminal deflection of nasal septum and 2 cases with high set deflection accepted small curve incision in front of the deflection. [Results] 39 patients obtained satisfactory consequence, and the clinical symptoms caused by deflection of nasal septum disappeared or eased. The patients were followed-up for six months to twenty-four months, and no perforation, saddle nose, nasal conglutination or other complications were found. [ Conclusion] Nasal endoscopic revisional operation under nasal endoscope is an effective way to retrieve the failures of nasal septal constructions, and it can gain satisfactory effects, since it aims directly at different clinical complains.