鼻内镜下鼻中隔软骨、筛骨垂直板或耳屏软骨修补鼻中隔穿孔

Chondroseptum, Ethmoid Perpendicular Plate and Tragus Cartilage in Repairing of Nasal Septum Perforation under Endoscopy

目的:探讨鼻内镜下应用颞肌筋膜包裹自体鼻中隔软骨、筛骨垂直板或耳屏软骨修补鼻中隔穿孔的临床疗效。方法:回顾性分析2007年8月至2014年8月我院17例行鼻内镜下鼻中隔穿孔修补术患者的临床资料,所有患者术前均行鼻内镜及副鼻窦CT检查,术中分别采用颞肌筋膜包裹自体鼻中隔软骨、筛骨垂直板或带软骨膜的自体耳屏软骨,形成骨性支架,修补鼻中隔穿孔。术后均予抗生素抗感染,并用碱性成纤维细胞生长因子凝胶涂抹创面,促进周边黏膜向穿孔处生长。结果:17例患者均一次修复成功,术后1~2月穿孔处被黏膜完全覆盖,鼻中隔正常解剖结构得以恢复,随访1~3年无再次穿孔,鼻中隔穿孔产生的临床症状术后改善明显。结论:鼻内镜下应用鼻中隔软骨、筛骨垂直板或耳屏软骨修补鼻中隔穿孔安全、有效、简便,值得推广。

Objective： To evaluate the clinical effects of nasal endoscopic neoplasty in treatment of nasal septum perforation with chondroseptum, ethmoid perpendicular plate combinded with temporal muscle fascia or tragus cartilage. Methods： A prospective cohort study of 17 patients with nasal septum perforation was underwent in our houspital fi：om August lth in 2007 to August 31th in 2014. All patients were examined by CT scan and nasal endoscopy as a preoperative routine. Nasal endoscopic neoplasty was performed with chondroseptum, ethmoid perpendicular plate combinded with temporal muscle fascia and tragus cartilage. After the operation, antibiotic was given and basic fibroblast growth factor gel was used to promote nearby tissues grow towards the perforations. Results： All cases were successfully repaired with the squamous epithelization from 1 to 2 months, and the normal anatomy of nasal septum was restored. No surgical complications happened during followed up from 1 to 3 years. Conclusion： Nasal endoscopic neoplasty for nasal septum perforation with chondroseptum, ethmoid perpendicular plate and tragus cartilage is safe, convenient and effective.