鼻内镜下鼻中隔偏曲矫正治疗鼻内接触性头痛

Treatment of contact headaches by correcting the nasal septum under endoscopy

目的探讨鼻内镜下鼻中隔偏曲矫正对鼻内接触性头痛的治疗效果。方法对2006～2010年收治的58例鼻中隔偏曲患者进行回顾性分析,所有患者均符合接触性头痛的诊断标准,其中男35例,女23例,平均年龄31.5岁,患病时间5个月～7年,所有患者均行鼻内镜下微创手术矫正结构异常。对于鼻中隔偏曲者,行鼻中隔偏曲矫正术;黏膜肥厚及中隔中甲予以切吸器切削之;中鼻甲反向弯曲者,将中鼻甲骨折内移;泡状中鼻甲或中鼻甲肥大者,去除部分中鼻甲;下鼻甲肥大者行下鼻甲黏骨膜下切除术或下鼻甲骨折外移术。结果经过6个月至2年的随访,58例患者中治愈39例,有效16例,无效3例,有效率为94.83%。结论鼻中隔偏曲是导致鼻内接触性头痛的常见病因,手术矫正是治疗鼻内接触性头痛的有效手段。

Objective To study the procedure of correcting the nasal septum with a nasal endoscope to treat contact headaches.Methods 58 cases,35 males and 23 females from 2006 and 2010,were reviewed.All the patients were confirmed as contact headaches.The average age was 31.5 yrs.The headache lasted from five months to seven years.Endoscopic surgery was applied to all the cases in order to modify the abnormal structure.All the patients underwent correction of the nasal septum.A powered microdebrider was applied to resect the hypertrophic mucosa or septum turbinate.For cases with middle turbinate recurvation,the turbinate was fractured and pushed inward.Partial resection of the middle turbinate was applied to the cases with concha bullosa or hypertrophic middle turbinate.Patients with hypertrophic inferior turbinate received submucous resection or out-fracture of the turbinate.Results Each case was follow-up for 6 to 24 months.Among the 58 cases,39 patients were cured,16 cases got better and 3 cases were ineffective.The effective rate was 94.83%.Conclusions Deviation of the nasal septum is a common cause of contact headaches.The effective therapy is nasal-septum-correction.