鼻内镜下重塑鼻腔结构治疗结构性鼻炎

Endoscopic nasal reshaping of the structure in structural rhinitis

目的探讨鼻内镜下重塑鼻腔结构治疗结构性鼻炎的方法和疗效。方法对123例伴有鼻腔、鼻窦结构异常的慢性鼻及鼻窦炎(chronic rhinosinusitis,CRS)患者,于Messerklinger进路开放病变鼻窦的同期矫正鼻腔、鼻窦的各种结构异常,包括:①鼻中隔偏曲患者,行鼻中隔黏膜下矫正术;②中鼻甲气化、中鼻甲肥厚伴骨质增生或中鼻甲反常曲线患者,行中鼻甲成形术;③下鼻甲肥厚伴骨质增生患者,行下鼻甲黏膜下成形术;④钩突肥大、钩突气化或钩突角度异常患者,常规切除钩突;⑤存在鼻丘气房、筛气房、额气房或钩突顶端发育异常致额隐窝狭窄的患者,对额隐窝及其毗邻气房进行处理。结果术后随访1～2年,治愈106例,有效14例,无效3例,总有效率97.56%。结论内镜手术同期重塑鼻腔结构治疗结构性鼻炎是一种值得推荐的方法。手术应以纠正鼻腔病理性改变、调整两侧气流的对称性分布为主,以维系正常通气功能。

OBJECTIVE To explore the methods and effects of endoscopic nasal structure reshaping for treatment of chronic rhinosinusitis（CRS）. METHODS One hundred and twenty-three cases of CRS patients with abnormal anatomy in nasal cavity and sinus were treated by the Messerklinger approach. At the same time varieties of anatomical abnormalities were corrected,including：①submucous resection of nasal septum,②submusous middle turbinate resection,③submusous inferior turbinate resection,④Uncinate process resection ⑤deal with frontal recess and its adjacent cells. RESULTS All patients were followedup for 1 to 2 years. One hundred and six cases were successful, 14 satisfied and 3 inefficient. The rate of full recovery was 97.56%. CONCLUSION Reshaping nasal structure during endoscopic surgery is a method worth recommendation for structural rhinitis.