三维CT辅助下三线减张鼻中隔矫正术疗效观察

Three-dimension CT assisted endoscopic surgery for correction of nasal septum deviation with three lines tension relaxing

目的探讨三维CT辅助鼻内镜下三线减张鼻中隔矫正的手术技巧及其疗效观察。方法回顾性分析78例鼻中隔偏曲患者,全部行鼻内镜下三线减张鼻中隔矫正术,术前采用三维CT重建技术对鼻中隔偏曲部位进行评估,术中选择性地将鼻中隔方形软骨尾端、鼻中隔软骨与筛骨垂直板结合处、鼻中隔软骨下端与犁骨、上颌骨鼻嵴与腭骨鼻嵴结合处等部位形成的三条张力线分离,将应力区软骨和骨质按照事先设计方案进行切除,消除导致鼻中隔偏曲的应力,从而达到矫正鼻中隔的效果。结果所有患者术后均随访3个月以上,其中治愈57例,好转21例。结论鼻内镜下三线减张鼻中隔矫正术安全可靠,效果满意,最大限度保留了鼻中隔正常组织结构。术前利用三维CT重建技术对手术方式进行具有设计,具有手术精细,并发症少等优点,值得临床推广。

Objective To explore the surgical technique and therapeutic effect of three-dimension CT assisted endoscopic surgery for correction of nasal septum deviation with three lines tension relaxing. Methods Clinical data of 78 patients with nasal septum deviation undergoing endoscopic surgery with three line tension relaxing correction were analyzed retrospectively. First a Killian incision was performed at the junction of the skin and mucous on the left side of the nasal septum under endoscope. Then the nasal septum cartilage was separated from the angle formed by two greater cartilages,perpendicular plate of the ethmoid bone,and the junction of vomer and maxilla at the nasal crest. This procedure was applied to correcting the deviation of nasal septum by releasing tension,which was named three lines tension relaxing correction. Finally,the deviated bone and cartilage was removed. Results Follow up was carried out for 3 to 6 months postoperatively. Of all the patients,57 cases got cured and 21 cases were improved. Conclusion With advantages of less invasion and fewer complications,the endoscopic surgery with three lines tension relaxing for correction of nasal septum deviation is an easy and efficient method,and is worthy of popularizing.