鼻内镜下歪鼻畸形矫正术

Correction of deviated nose under nasal endoscope

目的探讨应用鼻内镜矫正歪鼻畸形的手术方法。方法对80例歪鼻畸形患者术前行鼻骨CT三维重建，了解歪鼻畸形的局部形成状况。先在鼻内镜下行鼻中隔偏曲的矫正术，后经鼻前庭前小切口或梨状孔入路在鼻内镜辅助下行歪鼻畸形矫正术。结果术后1周、1个月、3个月及半年后随访，观察外鼻形状，并测量其偏离值。80例患者中矫正效果优者69例，良好者8例，不满意者3例。结论采用鼻内镜能充分显露骨折畸形愈合部位，螺旋CT三维重建鼻骨形态可在术前充分了解歪鼻畸形局部及周围情况，避免破坏整体框架，使得手术创伤小，手术时间短，术后反应轻，皮肤坏死可能性小等特点，鼻内镜下矫正歪鼻畸形具有临床应用价值。

Objective To evaluate the surgical effect on correction of deviated nose under nasal endoscope. Methods Eighty cases with deviated nose deformities were performed the preoperative three-dimensional reconstruction of nasal bone to observe the local formation of nasal deformities. Under the nasal endoscope, nasal septum deviation was corrected firstly, and then correction of deviated nose was adopted through the mini-incision on nasal vestibule or approach of anterior nasal aperture. Results The external nasal shape was ob- served and their deviated value was calculated by following up at 1 week, 1 month, 3 months and 6 months. Among 80 cases, 69 were excellent, 8 were good and 3 were disaffected. Conclusion Three-dimensional reconstruction CT is useful for the preoperative understanding of the local condition of external nose. Application of nasal endoscope can fully expose the surgical view to avoid damaging to overall framework, with such adventages of shorter operation, light response and small skin necrosis.