半导体激光辅助下手术治疗鼻瓣区狭窄

Semi-conductor laser assisting surgery in treatment of narrow nasal valve

目的探讨半导体激光辅助下手术治疗鼻瓣区狭窄的临床效果。方法回顾性分析鼻瓣区狭窄48例(62侧)的临床资料。根据形成狭窄的主要突起(或塌陷)部位,分成A型:内侧突起(26侧),B型:外、上侧凸起(包括夹角过小、鼻翼塌陷)(22侧)和C型:底部突起(14侧)。所有患者行半导体激光辅助下鼻瓣区扩大手术。术后随访1年。术前和术后1年,分别采用10 cm视觉模拟评分法(visual analog scale,VAS)评价手术结果。结果三种类型患者VAS评分术后1年较术前均有下降,差异有极显著统计学意义(P<0.001)。其中A型总有效率85%,B型总有效率72%,C型总有效率93%。术后未发现鼻塞症状加重者。结论用传统手术器械行鼻瓣区手术时会有很多困难。激光在分离目标组织时合理、灵活,可轻易去除突起组织,扩大鼻瓣区,术后较少形成瘢痕,手术安全,疗效明确、持久。

Objective To explore the effect of semi-conductor laser assisting surgery for narrow nasal valve. Methods The clinical data of forty-eight cases （62 nostrils） were retrospectively analyzed. All cases were divided into three types according to the location of sacristy （or collapse） caused narrow nasal valve. Type A：inner lateral （26 nostrils）. Type B： external and upper lateral（22 nostrils）. Type C： basal part（ 14 nostrils）. All cases were enlarged the nasal valve with semiconductor laser assisting surgery and were followed up one year. Pre-operative and one year post-operative 10 cm visual analog scale（VAS） results and subjective relief degree were analyzed. Results All postoperative VAS scores were significantly lower than pre-operative ones（P 〈0.01 ）. Type A： Total effective rate （excellent add effect） was 85%. Type B ： Total effective rate was 72%. Type C： Total effective rate 93%. No signifi- cant differences were found among three types. No one was worse than before. Conclusion Surfaces of bone and cartilage rounding nasal valve are irregular and tightly connected with connective tissues, skins etc. Semi-conductor laser is able to block the blood vessel, and has functions of cutting, gasify, and carbonization. Being reasonably used, laser can remove objective tissues and enlarge the nasal valve easily with less scars.