鼻内窥镜在鼻中隔粘膜下切除术中的应用

Appliance of Nasal Endoscope in Submucous Resection of Nasal Septum

目的 探讨鼻内窥镜技术行鼻中隔粘膜下切除的优缺点 ,改进鼻腔填塞材料。方法 1995年以来在鼻内窥镜下行鼻中隔粘膜下切除术 390例 ,其中单纯鼻中隔偏曲 2 6 8例 ,鼻中隔偏曲合并鼻窦炎、鼻息肉 12 2例 ,单纯鼻中隔切除术后填塞硅胶套 +海绵 ,其余填塞凡士林纱条。结果 390例均取得满意的鼻腔通气效果 ,无一例发生鼻中隔穿孔、血肿等手术并发症。结论 与传统的Killian手术相比较 ,鼻内窥镜技术属于亚显微手术 ,具有操作精细、灵活简便、损伤小、出血少、安全、切口无须缝合等特点 ,改进了的术后鼻腔填塞物 ,明显优于传统手术。

Objective To discuss the advantages and disadvantages between endoscopic submucous resection of nasal septum and traditional Killian's operation. To improve material rammed in nasal cavity. Method Three hundreds ninty patients (one hundred and seventeen of them were soldiers) with deviation of nasal septum were performed with mordern nasal endoscope. Among 390 patients, 268 had septum deviation only, 122 had septum deviation with nasal polyp and sinusitis. The former rammed with silica gel cover and sponge after surgery, the others rammed with Vaseline gauze bar. Result 390 patients were all satisfied with operation. None of them had perforation or hematoma with nasal septum. Conclusion Compared with traditional Killian's operation, Endoscopic submucous resection of nasal septum was provided with fine agility operation, little damnification, little bleeding, safety, no stitching cut and good benefit. Material rammed in nasal cavity was improved and this kind of operation was obviously superier to traditional Killian's operation.