空鼻综合征

Empty nose syndrome

目的 提出空鼻综合征 (emptynosesyndrome ,ENS)的概念 ,以提高耳鼻咽喉科医师对鼻甲手术的重视 ,加深对该手术医源性并发症的认识。方法 回顾性分析 1996～ 2 0 0 0年于白求恩医科大学第三临床学院耳鼻咽喉 头颈外科就诊的空鼻综合征患者 14例 ,均曾经历过包括鼻甲切除性手术在内的各种鼻腔手术 ,年龄 13～ 5 2岁。所有患者均行保守治疗 ,其中 5例病情较重行鼻中隔、鼻底粘骨膜下髂骨充填术。结果 所有患者在首次鼻腔手术后 6个月～ 5年内出现鼻塞及鼻腔和 (或 )鼻咽、咽部干燥感 ,6例有精神压抑症状 ,鼻腔检查可见鼻腔宽敞呈“筒状”。保守治疗有效 ,但疗效欠佳 ,手术治疗 12～ 2 0个月随访疗效满意。结论 过分的鼻甲切除性手术可导致继发性鼻腔粘膜萎缩及一系列伴发症状 ,空鼻综合征概念的提出旨在提醒耳鼻咽喉科医师谨慎地施行鼻甲手术 。

Objective The aim of this article is to present the concept of empty nose syndrome(ENS) and help ENT doctors take care of regular nasal turbinate surgery. Methods Fourteen patients who was diagnosed as ENS in our department were reviewed retrospectively. All patients had undergone various forms of nasal surgery (all had had turbinectomy). Their age ranged from 13 to 52 years. All patients were treated conservatively, among these patients 5 subjects who had more serious symptoms received submucous and subperiostal nasal implantation with ilium. Results All patients had nasal obstruction and dryness of nasal cavity、nasopharynx and oto pharynx in 6 months 5 years after their first nasal surgery, some presented symptoms of depression. Nasoscope examination showed all patients had a cylindrically enlarged nasal cavity. Conservative treatment was effective in most cases. The effectiveness of operative treatment was encouraging during short term follow up. Conclusion Extensive turbinectomy may cause secondary nasal mucosal atrophy and a series of subsequent symptoms. The presentation of this concept is to remind the ENT doctors prudently performing turbinectomy to avoid the occurrence of irreversible injury to the nasal cavity.